File Name: congenital muscular torticollis current concepts and review of treatment .zip
Atlas of Pediatric Surgery pp Cite as. Torticollis is characterized by tilting and rotation of the head and neck as a result of fibrosis and contracture of the sternocleidomastoid muscle. The clinical features, etiology and management are discussed. The term torticollis is derived from the Latin words tortus twisted and collum neck. Torticollis is an abnormal, asymmetrical head or neck position with a lateral head tilt. It is characterized by tilting and rotation of the head and neck as a result of fibrosis and contracture of the sternocleidomastoid muscle Figs. There are several causes of torticollis, and these are different in infants than in children and adolescents.
Adult presentation of neglected congenital muscular torticollis CMT is rare. Therefore, efficacy of surgical treatment for adult CMT is unclear. We experienced a case of neglected CMT in a year-old male patient and report the surgical result here. We conducted unipolar resection at the distal end of the sternocleidomastoid muscle SCM. After surgery, the range of neck movement and head tilt improved, and his appearance was cosmetically improved despite the long-standing nature of the deformity. We concluded that surgical management of adult patients with neglected congenital muscular torticollis may be a treatment option. Congenital muscular torticollis CMT is the third most common congenital musculoskeletal anomaly after dislocation of the hip and clubfoot [ 1 ].
Neglected or undiagnosed congenital muscular torticollis in adults is quite rare, although it is the third most common congenital deformity in the newborn 1. When left untreated at an early age, deficits in lateral and rotational range of motion can occur along with irreversible facial and skeletal deformities that develop over time. Subtle cases can go unnoticed until early adulthood, with predominant fibrotic replacement in the sternocleidomastoid SCM making physical therapy and chemodenervation mostly ineffective. Surgical intervention, in these cases, can prove effective in alleviating pain, improving function and cosmesis 2. We report an update on a previously reported case, misdiagnosed as cervical dystonia, which had undergone partial myectomy of the anterior belly of the SCM with some relief of symptoms but without total resolution after the correct diagnosis of fibromatosis colli 3.
Background : Positional plagiocephaly PP is a cranial deformation frequent amongst children and consisting in a flattened and asymmetrical head shape. PP is associated with excessive time in supine and with congenital muscular torticollis CMT. Few studies have evaluated the efficiency of a manual therapy approach in PP.
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