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Master Thesis

Évaluation de la douleur et résultats de la prise en charge multidisciplinaire des malades adressés au CHU de Caen pour suspicion de syndrome de la traversée thoraco-brachiale

Abstract : Introduction: This is a retrospective and observational study on the results of multidisciplinary management of patients referred to Caen teaching hospital for suspected thoracic outlet syndrome. Methods: The analysis included 32 patients benefiting from conservative management, drawn from the list of multidisciplinary consultations from 2018, and 35 patients who undergone TOS surgery between 2015 and 2018. The retained diagnoses were myofascial pain syndrome (MPS) and thoracic outlet syndrome (TOS). The primary outcome was pain progression. The secondary outcome was return to work. Results: In the medical group, 28 patients presented with MPS, 10 presented with TOS, including 6 mixed TOS. The surgical group included 35 TOS with 10 mixed, 19 venous TOS vs 16 neurogenic TOS, 22 chronic cases vs 13 acute cases. 68.8% of the medical group had no benefit in pain. They were 20% in the surgical group. 16.4% of our population was unable to return to work. TOS, acute TOS and the absence of painkiller use were prognostic factors for a successful evolution of pain. MPS was a prognostic factor for failure of the treatment. High-risk manual occupations, sick leaves before management, opioïds, antidepressant or anti epileptic drugs were associated with the inability to return to work. Within pain centre, 41.7% were able to return to work. Conclusion: Caen teaching hospital multidisciplinary consultation successfully differentiates chronic TOS and MPS, reserving surgery for the most severe cases. Management will be improved with an initial assessment of pain and QuickDASH and early cooperation with pain centre.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03152074
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Submitted on : Thursday, February 25, 2021 - 11:49:20 AM
Last modification on : Wednesday, March 17, 2021 - 3:32:36 AM

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CHEVET Erwan et DOZY Pierre-Ri...
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  • HAL Id : dumas-03152074, version 1

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Erwan Chevet, Pierre-Rick Dozy. Évaluation de la douleur et résultats de la prise en charge multidisciplinaire des malades adressés au CHU de Caen pour suspicion de syndrome de la traversée thoraco-brachiale. Médecine humaine et pathologie. 2020. ⟨dumas-03152074⟩

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