CONGENITAL MUSCULAR TORTICOLLIS CURRENT CONCEPTS AND REVIEW OF TREATMENT PDF

E-mail: moc. This article has been cited by other articles in PMC. Abstract Congenital muscular torticollis CMT is a rare congenital musculoskeletal disorder characterized by unilateral shortening of the sternocleidomastoid muscle SCM. It presents in newborn infants or young children with reported incidence ranging from 0. Owing to effective shortening of SCM on the involved side there is ipsilateral head tilt and contralateral rotation of the face and chin.

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Congenital Muscular Torticollis is a common condition affecting the newborn child. It may be present at birth, but sometimes not discovered until the 6th-8th week, or even till much later. What are the other Names for this Condition? Age and Sex Distribution Congenital Muscular Torticollis is a common condition affecting the newborn child. It may be present at birth, but sometimes not discovered until the 6th-8th week, or even till much later The general incidence of this condition is around 1 in live births Both males and females are equally affected No racial preference is seen, and no worldwide geographical restriction is noted What are the Risk Factors for Congenital Muscular Torticollis?

A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others. Also, not having a risk factor does not mean that an individual will not get the condition.

It is always important to discuss the effect of risk factors with your healthcare provider. What are the Causes of Congenital Muscular Torticollis? Etiology The primary basis of Congenital Muscular Torticollis is a contraction or excessive shortening of the sternocleidomastoid muscle SCM located in the neck, leading to slanting of the head towards one side and limiting muscular motion range This may occur due to a host of factors and there are several explanations why this damage and muscle impairment might take place.

These include: Intrauterine crowding, traumatic neck muscle injury during delivery, compartment syndrome due to tissue compression, inherited abnormalities of the vertebrae or spinal cord What are the Signs and Symptoms of Congenital Muscular Torticollis?

In some infants with Congenital Muscular Torticollis, the wry neck appearance may be mild and almost invisible. However, it may progressively worsen if left untreated, causing facial asymmetry.

CMT presents the following signs and symptoms: Head tilted to one side mostly to the right side , with limited movement of the neck. The abnormal head position becomes apparent after a few months Due to the baby frequently sleeping on one side, the head or skull base may flatten and acquire an asymmetrical shape A soft tumorous swelling may be noticed in the neck region, which may be present for months, on the side towards which the head slant is observed Extreme head postures may create breastfeeding issues; feeding from one of the breasts, may be difficult How is Congenital Muscular Torticollis Diagnosed?

A simple physical examination of the neck by the pediatrician, with study of birth history may be conclusive enough to arrive at a Torticollis diagnosis.

Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. What are the possible Complications of Congenital Muscular Torticollis? Complications of Congenital Muscular Torticollis are mainly linked to the extent of the condition severe twisted neck situation , and the presence of secondary medical disorders. How is Congenital Muscular Torticollis Treated? The treatment measures for Congenital Muscular Torticollis are basically meant to prevent worsening of the condition and correct the defect.

The interventions could be surgical or non-surgical. Surgical methods are mainly used if the condition is classified as severe by the physician and do not improve after non-surgical procedures, which form the usual line of treatment. The management measures include: Physical therapy; to gently help increase range of motion and provide proper shape to the head, to prevent further muscle contracture and loss of muscle function.

This is achieved by using age-suitable stretching and musculoskeletal strengthening exercise program, which helps in decreasing muscle fatigue and stress Use of special child neck collar called TOT collar , after the age of 4 months Application of warm compress, or heat Surgical techniques are employed if symptoms persist after one year of conservative management of the condition.

This is then followed by post-surgical physiotherapy If required, Botox injections may be used to improve and strengthen the muscle condition How can Congenital Muscular Torticollis be Prevented? In some cases Congenital Muscular Torticollis may be preventable like ensuring that baby delivery process is performed carefully.

Though, in most cases it cannot be prevented What is the Prognosis of Congenital Muscular Torticollis? Rosemont, IL Phone:

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Curr Opin Pediatr. Congenital muscular torticollis: current concepts and review of treatment. Do TT 1. Besides the benign muscular tightness of the sternocleidomastoid muscle leading to the classic head position, the differential diagnosis of the wry neck include sequelae to inflammatory, ocular, neurologic or orthopedic diseases.

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