All issues > Volume 52(11); 2009

Original Article

Korean J Pediatr. 2009;52(11):1273-1278. Published online November 15, 2009.

Clinical characteristics and courses of congenital muscular torticollis

Kyong Eun KE Choi¹, Hee Chul HC Lee¹, So Young SY Youn¹, Jung Mi JM Chun¹, Son Moon SM Shin¹, Byung Hee BH Han², Yong Taek YT Lee³

¹Department of Pediatrics, Cheil General Hospital and Women’s Health Care Center, College of Medicine, Kwandong University, Seoul, Korea
²Department of Radiology, Cheil General Hospital and Women’s Health Care Center, College of Medicine, Kwandong University, Seoul, Korea
³Department of Rehabilitation, Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University, Seoul, Korea

Correspondence Jung Mi JM Chun ,Email: cjm519@medimail.co.kr

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¡¾1.0, POST: 2.7¡¾1.6). 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¡¾2.5, POST: 2.6¡¾1.9). 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.

Keywords :Torticollis, Obstetrical, Risk factors, Plagiocephaly