Complete tight fibrous band release and resection in congenital muscular torticollis

Congenital Muscular Torticollis-Case Report and an Effective Treatment Plan

“…The reported incidence varies between 0.4 and 1.9% and there appears to be male predominance with a relative ratio of 3:2 [2,5,7]. In the ordinary way it is the third most common musculoskeletal anomaly that affects children (after hip dislocation and club foot) [1,5,9]. The right side seem to be more affected than the left and there is an equal sex distribution [9].…”

“…The right side seem to be more affected than the left and there is an equal sex distribution [9]. A world of difference exists with the science of torticollis and various theories have been proposed, but its true etiology remains obscure [1,5,6,9]. On one level many have pointed a finger at injury during birth [1], with the suggestion put on the table that a haematoma takes wing within the SCM muscle and subsequently be in the grip of fibrous contracture, but on another level it has been diagnosed in babies born by elective caesarean section which suggests a prenatal cause [5].…”

“…A world of difference exists with the science of torticollis and various theories have been proposed, but its true etiology remains obscure [1,5,6,9]. On one level many have pointed a finger at injury during birth [1], with the suggestion put on the table that a haematoma takes wing within the SCM muscle and subsequently be in the grip of fibrous contracture, but on another level it has been diagnosed in babies born by elective caesarean section which suggests a prenatal cause [5]. On the understanding that oligohydramnios causes restricted fetal posture and may contribute to the underlying pathophysiology of torticollis, obstructed traumatic delivery may therefore be its effect rather than its cause.…”

“…Surgical options for the affected SCM muscle include unipolar release at the sternoclavicular origin, bipolar open tenotomy [9,12], bipolar release [5], transsection of the middle of the muscle, Z-plasties on the attachments of the sternal muscle [12], and complete excision of the muscle [1]. In many instances the enveloping deep cervical fascia has contracted and must be divided to complete the release [9].…”

“…The word torticollis comes from a Latin word which means twisted neck [1]. By definition it is a deformity, congenital or acquired, characterised by lateral inclination of the head to the shoulder, with torsion of the neck and deviation of the face [2].…”