Surgical management of congenital torticollis in children older than 7 years with an average 10-year follow-up

Abstract

The aim of the present study is to present the results of the surgical management of late presenting cases of congenital muscular torticollis. Between 1990 and 2010, 31 cases of late presenting congenital muscular torticollis were managed surgically in our department. Postoperatively, head halter traction was applied for 10 days; a cervical brace was applied for 5 weeks, followed by a soft one collar for 3 months. The final result was assessed on the basis of the criteria of Cheng and Tang. In total, 84% of patients achieved an excellent final result and 16% of the patients achieved a good result. Our results indicated that in children older than 7 years, surgical release combined with appropriate orthosis and a structured physiotherapy regime can lead to satisfactory results.

Reversal of Degenerative Changes in Cervical Spine Following Bipolar Release in a Neglected Case of Congenital Muscular Torticollis: A Case Report

“…Neglected cases of CMT require surgery for the release of tethered elements and conservative treatments are no longer a solution for these patients [3]. Surgical techniques for SCM release are unipolar release, bipolar release, and bipolar release with Z-plasty lengthening [4]. Age, the severity of symptoms, and the surgeon's preference are the factors to be considered for choosing the technique when surgical intervention is indicated [4].…”

“…Surgical techniques for SCM release are unipolar release, bipolar release, and bipolar release with Z-plasty lengthening [4]. Age, the severity of symptoms, and the surgeon's preference are the factors to be considered for choosing the technique when surgical intervention is indicated [4].…”

“…Younger patients and those with moderate severity may be managed by the unipolar release which provides the least invasion and best cosmetic results. However, this technique is not suitable for patients with severe deformity due to the higher possibility of recurrence [4].…”

“…Surgical intervention is reserved for patients who fail to respond to non-surgical treatments and those who suffer recurrences following previous treatment [3]. CMT can rarely be seen in adults if the patients defer treatment and in situations that patients are neglected due to economic, cultural, and social shortcomings [4].…”

Surgical Treatment of Congenital Torticollis, at the Shriners Hospital, Mexico City

“…4 Untreated congenital muscular torticollis may cause facial and cranial asymmetry accompanied by a limited range of movement. 5,6 Among the surgical options are percutaneous tenotomy, Z-plasty, unipolar or bipolar resection of the sternocleidomastoid muscle, as well as endoscopy-assisted tenotomy and radical muscle resections. Surgical treatment is indicated for patients older than one year of age who have not improved with conservative treatment.…”