Treatment of Congenital Muscular Torticollis with Unipolar Release.

Park, Myong Chul; Song, Hyun Suk; Kim, Chee Sun; Yim, Shin Young; Park, Dong Ha; Pae, Nam Suk; Lee, Il Jae

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2009;36(1):38-45.
Published online January 1, 2009.

Treatment of Congenital Muscular Torticollis with Unipolar Release.

Myong Chul Park, Hyun Suk Song, Chee Sun Kim, Shin Young Yim, Dong Ha Park, Nam Suk Pae, Il Jae Lee

¹Department of Plastic and Reconstructive Surgery, School of Medicine, Ajou University, Suwon, Korea. mpark@ajou.ac.kr
²Department of Physical Medicine and Rehabilitation, School of Medicine, Ajou University, Suwon, Korea.

Abstract

PURPOSE
The congenital muscular torticollis is a neck deformity involving shortening of the sternocleidomastoid muscle, which is detected at birth or shortly after birth. This childhood disease is the third most common congenital musculoskeletal anomaly. The indication for surgery is a persistent head tilt with dificit of passive rotation and lateral bending of the neck and a tight band or tumor in the sternocleidomastoid muscle even after physical therapy. The purpose of this article is to report surgical outcomes with patients who had no or little response to physical therapy. METHODS: Surgery was performed on 29 patients and their average age was 4.1 years(from 6 months to 20.1 years). The unipolar open release and partial myectomy were done in 28 cases and the muscle lengthening was done in 1 case. Physical therapy was started from postoperative seventh day. Follow-up period was ranged from 2 months to 5.4 years(mean follow-up, 20.4 months). Result: There were neither rotation nor lateral bending deficit after surgical treatment. Mild head tilt was noticed in 3 cases and residual bend was observed in 4 cases. The subjective assessments of surgical results by parents were excellent.
CONCLUSION
Our surgical outcome encourages the surgical treatment of congenital muscular torticollis for patients who failed to respond to physical therapy.

Keywords: Congenital muscular torticollis; Sternocleidomastoid muscle; Unipolar release and partial myectomy