Bilateral non-traumatic second rib fracture after bilateral first rib resection for TOS

[...]rib fracture after first rib resection can therefore be compared with first rib fractures in patients who have not undergone first rib resection. Non-traumatic fractures occur without adequate trauma and are regarded as stress fractures and usually can be found in the weakest portion of the rib. 3- 8 Fractures present with upper chest pain and tenderness. 3 Some authors have doubted the existence of this type of fracture and classify it as a congenital anomaly. 10 Most authors explain the stress fracture by the anatomy of the first rib. 3- 8 The rib is broad and flat and weakened by the groove where the subclavian artery crosses it.