Surgical correction of muscular torticollis in the older child

Area of Science:

• Pediatric Orthopedics
• Surgical Outcomes
• Musculoskeletal Disorders

Background:

• Muscular torticollis is a common condition in children.
• Surgical intervention, specifically sternocleidomastoid muscle release, is a treatment option.
• Optimal timing for surgical release remains a consideration.

Purpose of the Study:

• To evaluate the long-term functional and cosmetic outcomes of late surgical release for muscular torticollis.
• To determine the efficacy of distal open release of the sternocleidomastoid muscle in pediatric patients.
• To identify patient factors influencing surgical success.

Main Methods:

• A retrospective follow-up study of 33 children (ages 6-16) treated for muscular torticollis.
• All patients underwent distal open release of the sternocleidomastoid muscle.
• Preoperative and postoperative assessments utilized a rigid scoring system to evaluate function and cosmesis.

Main Results:

• All 33 patients demonstrated improvement in both function and cosmetic appearance post-surgery.
• Children under 12 years of age achieved the highest success rates, with 71% excellent or good results.
• The follow-up period ranged from 2 to 10.5 years, indicating sustained benefits.

Conclusions:

• Late surgical release of the sternocleidomastoid muscle for muscular torticollis can provide acceptable long-term results.
• Early surgical intervention (under 12 years) appears to yield superior outcomes.
• Distal open release is an effective surgical technique for improving function and cosmesis in pediatric muscular torticollis.