Congenital Muscular Torticollis-Case Report and an Effective Treatment Plan

Mohan, Muralee; Bhat, Smitha; Prasad, Rajendra; Sharma, S. M.; Jain, Tarun Lunawat

doi:10.1007/s12663-011-0313-y

Cited by 6 publications

(6 citation statements)

References 13 publications

(40 reference statements)

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“…Congenital muscular torticollis (CMT) is a congenital condition that delays gross motor skills development in infants [ 5 ]. CMT is characterised by the shortening or excessive contraction of the sternocleidomastoid (SCM) muscles, which causes lateral flexion of the head to the side of torticollis, with rotation towards the opposite side and other accompanying asymmetries [ 38 ]. CMT can contribute to plagiocephaly, developmental dysplasia of the hip, brachial plexus trauma, and anomalies of the feet or lower limbs [ 8 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Congenital Muscular Torticollis—Current Understanding and Perinatal Risk Factors: A Retrospective Analysis

Płomiński,

Olesińska,

Kamelska-Sadowska

et al. 2023

Healthcare

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Introduction: Congenital muscular torticollis (CMT) is an asymmetrical head position resulting from structural changes in the sternocleidomastoid (SCM) muscle that occurs early during a child’s development or due to perinatal trauma. Children with CMT exhibit a marked imbalance in tension between the SCMs. In a typical clinical picture, an ultrasound scan is performed to reveal characteristic lesions, such as tissue fibrosis or post-traumatic changes. An early diagnosis of CMT in newborns and the implementation of treatment offer the chance of a complete resolution. Torticollis treatment aims to restore the SCM’s normal function. Surgical treatment is performed when conservative methods fail to improve the patient’s condition. The indications that surgery is needed include a marked shortening of the SCM, persistent fibrosis in the muscle, constant head and facial asymmetry, and rotation or lateral flexion in the cervical spine restricted by >15°. Of all the newborn and infant anomalies, congenital torticollis is the third most common after hip dysplasia and equinovarus deformities. Some authors demonstrate that torticollis coexists with hip dysplasia. Aim: The aim of this study was to collect data on infants referred to paediatric rehabilitation and to identify the risk factors associated with CMT in this group of patients, as well as to assess demographic and clinical characteristics concerning risk factors. Materials and methods: The target population for this retrospective study consisted of 111 infants aged 0 to 5 months born in Poland and diagnosed with and undergoing treatment due to CMT. The following were determined: the relationship between the side of the CMT location and the type of delivery (caesarean section vs. vaginal), the relationship between the body weight at birth and the side of the CMT location, the relationship between the extent of SCM thickening and the type of delivery, and the incidence of CMT depending on the order of delivery. Results and conclusions: The data revealed that CMT is less common in female infants (n = 51, 46%) compared to male (n = 61, 54%) infants, in whom a greater birth weight was reported (p < 005). Seventy-six percent (76%) of the paediatric patients with CMT were the offspring of primipara mothers. More often, children born via vaginal delivery had left-sided torticollis with a more significant broadening of the SCM, as shown on ultrasound scans, than right-sided torticollis. Theories of torticollis development pathophysiology should be deepened and systematised, and further research is needed.

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Section: Discussionmentioning

confidence: 99%

Congenital Muscular Torticollis—Current Understanding and Perinatal Risk Factors: A Retrospective Analysis

Płomiński,

Olesińska,

Kamelska-Sadowska

et al. 2023

Healthcare

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show abstract

“…Los casos que no se diagnostican con prontitud desarrollan con el crecimiento deformaciones y asimetrías craneofaciales que incluyen deformación plagiocefálica, retrusión del cigoma, distopia orbitaria (15), desviación lateral de la mandíbula (17), alteración del plano orbitario y oclusal (14) y maloclusiones dentarias (3,16,18,19).…”

Section: Discussionunclassified

“…Se han conseguido mayores mejoras en cuanto a corrección de la deformidad y la asimetría ósea en los pacientes intervenidos quirúrgicamente antes de los 5 años de edad (26), además la deformación plagiocefálica es más difícil de corregir tras la pubertad por la falta de potencial para el crecimiento y remodelado óseo (3). Sin embargo otros autores son partidarios de que el momento quirúrgico no sea determinado por la edad sino por el grado de madurez del paciente para que sea capaz de realizar satisfactoriamente el programa de ejercicios posquirúrgicos, encontrando mejores resultados en cuanto a movilidad, cicatrización quirúrgica y grado de inclinación de la cabeza (27).…”

Section: Discussionunclassified

“…A nivel intraoral estos pacientes con tortícolis muscular congénita, pueden presentar desviación de la línea media dentaria inferior hacia el lado afectado, mordida cruzada unilateral en ese mismo lado, así como una tendencia a la relación molar de clase II en ese lado afecto y relación de clase III en el lado contrario (3,16,18,19).…”

Section: Deformaciónunclassified

“…La incidencia de TMC es entre un 0,4 y un 1,9% de los recién nacidos y la etiopatogenia es muy contro-vertida, se cree que podría estar causada por traumas durante el nacimiento, partos difíciles, presentación de nalgas, cesáreas o usos de fórceps, aunque otros autores apuntan únicamente a factores prenatales (3)(4)(5)(6).…”

Section: Introductionunclassified

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