Adult presentation of congenital muscular torticollis A SERIES OF 12 PATIENTS TREATED WITH A BIPOLAR RELEASE OF STERNOCLEIDOMASTOID AND Z-LENGTHENING

作者：Patwardhan S; Shyam A K^*; Sancheti P; Arora P; Nagda T; Naik P

来源：Journal of Bone and Joint Surgery-British Volume, 2011, 93B(6): 828-832.

DOI：10.1302/0301-620X.93B6.26232

Adult presentation of neglected congenital muscular torticollis is rare. We report 12 patients with this condition who underwent a modified Ferkel's release comprising a bipolar release of sternocleidomastoid with Z-lengthening. They had a mean age of 24 years (17 to 31) and were followed up for a minimum of two years. Post-operatively a cervical collar was applied for three weeks with intermittent supervised active assisted exercises for six weeks. Outcome was assessed using a modified Lee score and a Cheng and Tang score. The mean pre-operative rotational deficit was 8.25 degrees (0 degrees to 15 degrees) and mean lateral flexion deficit was 20.42 degrees (15 degrees to 30 degrees), which improved after treatment to a mean of 1.67 degrees (0 degrees to 5 degrees) and 7.0 degrees (4 degrees to 14 degrees) after treatment, respectively. According to the modified Lee scoring system, six patients had excellent results, two had good results and four had fair results, and using the Cheng and Tang score, eight patients had excellent results and four had good results.
Surgical management of adult patients with neglected congenital muscular torticollis using a modified Ferkel's bipolar release gives excellent results. The range of neck movement and head tilt improved in all 12 patients and cosmesis improved in 11, despite the long-standing nature of the deformity.

• 出版日期2011-6