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Journal of the Korean Academy of Rehabilitation Medicine 1992;16(1):42-50.
Results of the conservative management in congenital musculartorticollis.
Kim, Myeong Ok , Kim, Sei Joo
Department of Rehabilitation Medicine, Korea University College of Medicine
선천성 근성 사경의 보존적 치료 효과에 관한 임상 고찰
김명옥, 김세주
고려대학교 의과대학 재활의학교실

Torticollis is a deformity of neck that shows tilting of the head toward the affected side and rotation of the chin toward the opposite side. In many cases with this condition, unilateral tightness of the sternocleidomastoid muscle is found frequently with fibrous tumor.

For the infants with this deformity, stretching of the involved sternocleidomastoid muscle with specific handling and positioning used to be instituted.

A retrospective review of 95 patients with congenital muscular torticollis seen between 1986 and 1991 was performed. In 30 cases, it was supplemented by questionnaires, permitting a eight- to 71-month follow up. The results were as follow:

1) There were 51 males and 44 females. Fifty four cases were on the right side and forty cases on the left side, and one case was of bilaterality. There was no sex difference between male and female, with favor in former side, but significant difference between the fight and left side (p<0.01).

2) Torticollis was mild to moderately severe in 77.9% of cases. The mass in the sternocleidomastoid muscle or head tilting was found before eight weeks of age for 92.6% of patients. The First visit to the clinic before eight weeks was made in 59.0%, and before 6 months I 85.3%.

3) There were normal spontaneous delivery in 60.0%, instrumental delivery in 12.6%, and by Cesarean section in 27.4%. The breech presentation was 19 cases (20.0%).

4) Associated deformity initially was observed in 14.7% of cases, which included strabismus, dislocation of hop, and scoliosis.

5) At 16 weeks, the torticollis had been conservatively resolved in 46.3%.

6) Torticollis has been completely resolved in 70.3% of patients when treated before 12 weeks of age, but only in 32.3% when treated after 12 weeks. And also, torticollis has been resolved in 77.8% of patents when treated over 30 times, but 44.0% when treated under 30 times.

7) Of the 30 cases with follow up, 11 cases (36.6%) improved, 17 cases (56.7%) remained the same as the condition when conservative treatment terminated, and 2 cases (6.7%) became worse, 6 children had surgical release of strnocleidomastoid muscle.

As conclusion, slow steady stretch exercise of sternocleidomastoid muscle with early diagnosis seems more successful in recovery than no exercise although natural resolution may occur in may cases.

Key Words: Congenital muscular torticollis, Conservative management, Follow up


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