Torticollis.

Area of Science:

• Pediatric Orthopedics
• Reconstructive Surgery
• Physical Medicine

Background:

• Torticollis presents as an isolated deformity or a symptom of underlying neuromuscular or central nervous system disorders.
• Congenital muscular torticollis is characterized by a restricting band within the sternocleidomastoid muscle, often presenting with a palpable mass.
• Aesthetic improvement and functional recovery are primary goals in managing torticollis.

Purpose of the Study:

• To outline the indications, principles, and surgical techniques for managing congenital muscular torticollis.
• To emphasize the importance of early intervention for optimal craniofacial asymmetry reversal.
• To discuss various surgical options and their expected outcomes.

Main Methods:

• Surgical intervention is indicated for congenital muscular torticollis unresponsive to conservative treatments like physiotherapy and stretching.
• Key surgical principles include identification and release of restricting bands, ensuring full range of motion, and prompt resumption of physical therapy.
• Inferior open tenotomy of the sternocleidomastoid muscle is a commonly recommended and reliable procedure.

Main Results:

• Surgical release of the sternocleidomastoid muscle effectively addresses the restricting bands causing torticollis.
• Early surgical intervention, ideally before school age, maximizes the potential for reversing craniofacial asymmetry.
• Postoperative physical therapy is crucial to prevent scar contracture and ensure functional recovery.

Conclusions:

• Congenital muscular torticollis, particularly when resistant to conservative care, benefits from surgical management.
• Optimal surgical outcomes, including correction of asymmetry, are achieved with early intervention.
• Careful surgical technique and diligent postoperative rehabilitation are essential for successful management.