Abstract
Background/Purpose: The main objectives of this study were to define the clinical patterns and characteristics
of congenital muscular torticollis (CMT) presented in the first year of life and to
study the outcome of different treatment methods. Methods: This is a prospective study of all CMT patients seen in 1 center over a 12-year period
with uniform recording system, assessment methods, and treatment protocol. Results: From a total of 1,086 CMT infants, 3 clinical subgroups of sternomastoid tumor (SMT;
42.7%), muscular torticollis (MT; 30.6%), and postural torticollis (POST; 22.1%) were
identified. The SMT group was found to present earlier within the first 3 months and
was associated with higher incidence of breech presentation (19.5%), difficult labor
(56%), and hip dysplasia (6.81%). Severity of limitation of passive neck rotation
range (ROTGp) was found to correlate significantly with the presence of SMT, bigger
tumor size, hip dysplasia, degree of head tilt, and craniofacial asymmetry. Conclusions: A total of 24.5% of the patients with initial deficits of passive rotation of less
than 10° showed excellent and good outcome with active home positioning and stimulation
program. The remaining cases with rotation deficits of over 10° and treated with manual
stretching program showed an overall excellent to good results in 91.1% with 5.1%
requiring subsequent surgical treatment. The most important prognostic factors for
the necessity of surgical treatment were the clinical subgroup, the ROTGp, and the
age at presentation (P <.001). J Pediatr Surg 35:1091-1096. Copyright © 2000 by W.B. Saunders Company.
Keywords
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Article info
Footnotes
☆Address reprint requests to Jack C.Y. Cheng, MD, FRCSEd (Orth), Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, 5th Floor, Clinical Sciences Building, Prince of Wales Hospital, Shatin, NT, Hong Kong.
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Copyright
© 2000 W.B. Saunders Company. Published by Elsevier Inc. All rights reserved.
