Korean J Pediatr.  2009 Nov;52(11):1273-1278. 10.3345/kjp.2009.52.11.1273.

Clinical characteristics and courses of congenital muscular torticollis

• Choi KE
• Lee HC
• Youn SY
• Chun JM
• Shin SM
• Han BH
• Lee YT

• KMID: 2281033
• DOI: http://doi.org/10.3345/kjp.2009.52.11.1273

Abstract

PURPOSE
Congenital muscular torticollis (CMT), a common musculoskeletal disorder in infants, is characterized by the rotation and flexion deformity of the neck caused by sternocleidomastoid muscle shortening. We investigated the clinical courses and perinatal risk factors of CMT. METHODS: Less than 6-month-old patients (98; M:F = 60:38) diagnosed with CMT between February 2007 and August 2008 were classified into 2 clinical subgroups, namely, SMT (sternocleidomastoid tumor) and POST (postural torticollis). All the patients were physically and neurologically examined prospectively and their cervical X-rays and ultrasonographies were obtained. Their medical histories about perinatal problems were recorded. Of the 98 patients, 45 with normal range of motion were taught passive physical exercises and 43 were referred to the Department of Rehabilitation for undergoing manual stretching therapy. RESULTS: The mean age at initial assessment was 2.2 months (SMT: 1.4+/-1.0, POST: 2.7+/-1.6). SMT presented earlier than POST. All ophthalmologic examinations and cervical X-rays were normal. SMT was associated with higher incidence of caput succedaneum and cephalhematoma. POST was highly associated with plagiocephaly. Mean duration of rehabilitative physical therapy was 3.7 months (SMT: 4.6+/-2.5, POST: 2.6+/-1.9). POST resolved earlier than SMT. Of the 88 patients with follow-up, 87 had total resolution and only 1 had residual torticollis. CONCLUSION: All the patients received early treatment with passive stretching exercises. CMT was associated with perinatal problems and had various risk factors such as obstetrical problems.

Keyword

Torticollis; Obstetrical; Risk factors; Plagiocephaly

MeSH Terms

Congenital Abnormalities
Exercise
Follow-Up Studies
Humans
Incidence
Infant
Muscle Stretching Exercises
Muscles
Neck
Plagiocephaly
Prospective Studies
Reference Values
Risk Factors
Torticollis
Torticollis