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Arterial thoracic outlet syndrome (TOS) is a rare vascular abnormality. Its common cause is a cervical rib but it is seldom detected secondary to trauma of the clavicle, particularly in association with surgical repair of a fractured clavicle. An athletic 45-year-old man developed a recurrent ischaemic upper limb after repair to a non-union fractured clavicle. He underwent multiple separate procedures including embolectomy, angioplasty, thrombolysis and subclavian stent insertion. Definitivedoi:10.5580/13f8 fatcat:5i3g3tqc2fagrb2mkhanimeqdq