Acute torticollis secondary to rupture of the sternocleidomastoid

Trauma to the neck musculature and cervical spine is frequently caused by hyperextension injuries which may result in muscular spasm or rupture. Partial rupture of the sternocleidomastoid muscle with subsequent formation of a fibrotic band is an unusual cause of acute torticollis. The case of a 21-year-old man who developed an acute torticollis and cervical pain after a motor vehicle accident is presented. Computed tomography scan demonstrated 75% rupture of the left sternocleidomastoid muscle with fibrotic band replacing the absent muscle tissue. Neck range of motion was markedly decreased. The patient underwent a trial of muscle relaxants and intensive physical therapy with no significant improvement. Surgical release of the residual fibrotic band was performed, and the left deviation of the neck was reduced from 25 degrees preoperatively to 5 degrees postoperatively. With surgical release and intensive postoperative physical therapy, the patient regained full motion and strength of the cervical spine musculature.