EC Paediatrics

Research Article Volume 13 Issue 1 - 2024

Long Time Outcome of Surgical Bipolar with Z-Plasty Lengthening and Postoperative with or without Place Cast for Congenital Muscular Torticollis

Nguyen Ngoc Hung1*, Hoang Hai Duc2, Le Tuan Anh2 and Dao Dang Linh3

1A. Professor, Surgical Department, Hong Phat General Hospital, Hanoi City, Vietnam
 2Pediatric Orthopaedic Department, National Hospital for Pediatrics, Ha Noi City, Vietnam
 3Orthopedic Institute, 108 Hospital, Ha Noi City, Vietnam

*Corresponding Author: Nguyen Ngoc Hung, A. Professor, Surgical Department, Hong Phat General Hospital, Hanoi City, Vietnam.
Received: November 29,2023; Published: December 12, 2023




Objective: Comparing results between postoperative congenital muscular torticollis (CMT) with or without place cast, and the effectiveness of surgical bipolar muscle for congenital muscular torticollis.

Methods: This study was a retrospective study of 73 cases with sternocleidomastoid muscle from October 1994 to December 2005. Patients have divided two Variant. Postoperative variant 1 without place cast and variant with place cast. The degree of neck tilt and range of motion of the neck, flexion and limitation of rotation were recorded. The ultrasound, measure cervico-mandibular angle (CMA). Children had performed operation by bipolar Z-plasty. Post-operation, with or without immobilization. Operative results were according to assess by the score of Cheng.

Results: Seventy three patients have operated congenital muscular torticollis. Male: 31; female: 42. Right: 27; left: 46. Age at operation means 4.3698 years (± 1.6791). Age at time of last examination: 27.43836 (± 3.109065), length of follow-up (year): 23.1232 (± 2.9765). Fascial asymmetric at follow-up: No: 64; slight: 07; mild: 02. Last result: Excellent: 61; good: 10; acceptable final result (Excellent + good): variant 1 (35+5) 97.60%/variant 2 (26+5) 96.90% (P-value = 0.0218565). Improvement of limitation of rotation in variant 1/variant 2: 63.9%/52.7% (P value = 0.0856030); improvement of angle of head tilt in variant 1/variant 2: 86.6%/66.3% (P value = 0.146634). In this study, we divide two variant, compared with and without use place cast. Post-operation, the patients had bipolar Z-plasty to show the column of sternomastoid muscle, there isn’t immobilization are reduce surgical time and cost.

Conclusion: The diagnostic and evaluation of congenital muscular torticollis requires a systematic team approach with members from fields of radiology, physiotherapy, craniofacial surgery, orthopaedics, neuro- surgery and ophthalmology. Technical bipolar Z-plasty with good results and there isn’t immobilization.

 Keywords: Congenital Muscular Torticollis; Sternocleidomastoid Muscles; Translational Deformity; Facial Asymmetry

 

  1. Chen MM., et al. “Predictive model for congenital muscular torticollis: analysis of 1021 infants with sonography”. Archives of Physical Medicine and Rehabilitation11 (2005): 2199-2203.
  2. Binder H., et al. “Congenital muscular torticollis: results of conservative management with long-term follow-up in 85 cases”. Archives of Physical Medicine and Rehabilitation4 (1987): 222-225.
  3. Cho KH., et al. “Congenital muscular torticollis in siblings: a case report and literature review”. Journal of Korean Academy of Rehabilitation Medicine6 (2009): 731-734.
  4. Cheng JC., et al. “The clinical presentation and outcome of treatment of congenital muscular torticollis in infants--study of 1,086 cases”. Journal of Pediatric Surgery7 (2000): 1091-1096.
  5. Ling CM and Low YS. “Sternomastoid tumor and muscular torticollis”. Clinical Orthopaedics and Related Research 86 (1972): 144-150.
  6. Hollier L., et al. “Congenital muscular torticollis and the associated craniofacial changes”. Plastic and Reconstructive Surgery3 (2000): 827-835.
  7. Canale ST., et al. “Congenital muscular torticollis: a long-term follow-up”. Journal of Bone and Joint Surgery. American Volume6 (1982): 810-816.
  8. Tse P., et al. “Surgery for neglected congenital torticollis”. Acta Orthopaedica Scandinavica3 (1987): 270-272.
  9. Ling CM. “The influence of age on the results of open sternomastoid tenotomy in muscular torticollis”. Clinical Orthopaedics and Related Research 116 (1976): 142-148.
  10. Lim KS., et al. “Is sternocleidomastoid muscle release effective in adults with neglected congenital muscular torticollis?” Clinical Orthopaedics and Related Research4 (2014): 1271-1278.
  11. Yim SY., et al. “The laryngeal cough reflex in congenital muscular torticollis: is it a new finding?” American Journal of Physical Medicine and Rehabilitation 2 (2010): 147-152.
  12. Cheng CY and Tang SP. “Outcome of surgical treatment of congenital muscular torticollis”. Clinical Orthopaedics 362 (1999): 190-200.
  13. Ling CM. “The influence of age on the results of open sternomastoid tenotomy in muscular torticollis”. Clinical Orthopaedics and Related Research 116 (1976): 142-148.
  14. Tubby AH. “Deformities and diseases of bones and joints”. 2nd Volume 1. London, England: MacMillan (1912): 56.
  15. Alldred A. “Congenital muscular torticollis”. In Proceedings of the New Zealand Orthopaedic 20 Association. Journal of Bone and Joint Surgery. British Volume2 (1971): 358.
  16. Sage FP. “Congenital anomalies”. In Campbell’s Operative Orthopaedics, edited by A. S. Edmonson and A. H. Crenshaw. Ed. 6. St. Louis, C. V. Mosby, (1980): 1909-1912.
  17. Gourley IM. “Paroxysmal torticollis in infancy”. Canadian Medical Association Journal 5 (1971): 504-505.
  18. Chandler FA and Altenberg Alfons. ““Congenital” muscular torticollis”. Journal of the American Medical Association 7 (1944): 476-483.
  19. Paul T., et al. “Surgery for neglected congenital torticollis”. Acta Orthopaedica Scandinavica 3 (1987): 270-272.
  20. Davids JR., et al. “Congenital muscular torticollis: Sequela of intrauterine or perinatal compartment syndrome”. Journal of Pediatric Orthopaedics 2 (1993): 141-147.
  21. Engin C., et al. “Congenital muscular torticollis: is heredity a possible factor in a family with five torticollis patients in three generations?” Plastic and Reconstructive Surgery4 (1997): 1147-1150.
  22. Chandler FA and Altenberg Alfons. ““Congenital” muscular torticollis”. Journal of the American Medical Association 7 (1944): 476-483.
  23. Lidge RT., et al. “Congenital muscular torticollis”. Journal of Bone and Joint Surgery 39-A.5 (1957): 161-165.
  24. Hubert KF. “Congenital torticollis”. Journal of Bone and Joint Surgery 32-B (1950): 50.
  25. Conventry MB and Harris LE. “Congenital muscular torticollis in infancy”. Journal of Bone and Joint Surgery American Volume5 (1959): 815-822.
  26. Gray CFL. “Torticollis: Epicondylar fractures”. Lancet 2 (1957): 1935.
  27. Bianco AJ. “Congenital muscular torticollis”. Thesis, Graduate School, University of Minnesota (1958).
  28. Witzel O. “Beiträgezur Kenntniss der secundären Veränderungen beim musculären Schiefhalse”. Deutsche Zeitschrift für Chirurgie 18 (1883): 534-578.
  29. Fitzimmon HJ. “Congenital torticollis. Review of the pathological aspects”. New England Journal of Medicine 209 (1933): 66.
  30. Stromeyer GF. Beitrage zur operativez Orthopadik, oder Erfahrungen über die subcutane Durchschneidung verkürzter Muskeln und deren Sehnen. I-Iannover: Helwing. (1838).
  31. Admas JC. “Outline of orthopaedics”. Sixth edition. Edinburgh and London: E. & S. Livingstone Ltd. (1967): 146.
  32. Anderson W. “Clinical lecture on sterno-mastoid torticollis”. Lancet3619 (1893): 9-12.
  33. Wynne-Davies R. “Familial (Idiopathic) scoliosis”. Journal of Bone and Joint Surgery British Volume 50-24 (1958).
  34. Jahss SA. “Torticollis”. Journal of Bone and Joint Surgery 18 (1936): 1065.
  35. Middleton DS. “The pathology of congenital torticollis”. British Journal of Surgery70 (1930): 188-204.
  36. Hough D de N. “Congenital torticollis. A review and result study”. Surgery, Gynecology and Obstetrics 58 (1934): 972.
  37. Burstein FD and Cohen SR. “Endoscopic surgical treatment for congenital muscular torticollis”. Plastic and Reconstructive Surgery1 (1998): 20-26.
  38. Luther BL. “Congenital muscular torticollis”. Orthopedic Nursing3 (2002): 21-29.
  39. Ferkel RD., et al. “Muscular torticollis. A modified surgical approach”. Journal of Bone and Joint Surgery. American Volume7 (1983): 894-900.
  40. Canale ST., et al. “Congenital muscular torticollis. A long-term follow-up”. Journal of Bone and Joint Surgery. American Volume6 (1982): 810-816.
  41. Yu CC., et al. “Craniofacial deformity in patients with uncorrected congenital muscular torticollis: an assessment from three-dimensional computed tomography imaging”. Plastic and Reconstructive Surgery1 (2004): 24-33.
  42. Shim JS and Jang HP. “Operative treatment of congenital torticollis”. Journal of Bone and Joint Surgery British Volume 89 (2008): 934-939.
  43. Chen CE and Ko JY. “Surgical treatment of muscular torticollis for patients above 6 years of age”. Archives of Orthopaedic and Trauma Surgery 3-4 (2000): 149-151.
  44. Minamitani K., et al. “Results of surgical treatment of muscular torticollis for patients greater than 6 years of age”. Journal of Pediatric Orthopaedics 6 (1990): 754-759.
  45. Lim KS., et al. “Is sternocleidomastoid muscle release effective in adults with neglected congenital muscular torticollis?” Clinical Orthopaedics and Related Research4 (2014): 1271-1278.
  46. Patwardhan S., et al. “Adult presentation of congenital muscular torticollis: a series of 12 patients treated with a bipolar release of sternocleidomastoid and Z-lengthening”. Journal of Bone and Joint Surgery British Volume6 (2011): 828-832.
  47. Mikulicz J. “Uber die Exstirpation des Kopfnickers beim muskulren Schiefhals, nebst Bemerkungen zur Pathologic dieses Leidens”. Zentralblatt fur Chirurgie 22 (1895): 1-9.
  48. Moseley TM. “Treatment of facial distortion due to wryneck in infants by complete resection of the sternomastoid muscle”. American Surgeon 28 (1962): 698-702.
  49. Bernau A. “Langzeitresultate nach Schiefhalsoperation”. Zeitschrift fur Orthopadie 115 (1977): 875-890.
  50. Kamboh UA., et al. “Outcome of surgical treatment for neglected congenital muscular torticollis: A series of 28 adolescent patient”. Surgical Neurology International 13 (2022): 292.
  51. Lim KS., et al. “Is sternocleidomastoid muscle release effective in adults with neglected congenital muscular torticollis?” Clinical Orthopaedics and Related Research4 (2014): 1271-1278.
  52. Sudesh P., et al. “Results of bipolar release in the treatment of congenital muscular torticolis in patients older than 10 years of age”. Journal of Children's Orthopaedics 3 (2010): 227-232.
  53. Shim JS., et al. “Treatment of congenital muscular torticollis in patients older than 8 years”. Journal of Pediatric Orthopaedics 6 (2004): 683-688.
  54. Shim JS and Jang HP. “Operative treatment of congenital torticollis”. Journal of Bone and Joint Surgery British Volume7 (2008): 934-939.
  55. Patwardhan S., et al. “Adult presentation of congenital muscular torticollis a series of 12 patients treated with a bipolar release of sternocleidomastoid and Z-lengthening”. Journal of Bone and Joint Surgery British Volume 93-B (2011): 828-832.
  56. Patwardhan S., et al. “Adult presentation of congenital muscular torticollis. A series of 12 patients treated with a bipolar release of sternocleidomastoid and z-lengthening”. Journal of Bone and Joint Surgery British Volume 93-B (2011): 828-832.
  57. Abokresha AE. “Cutting of origin and insertion of sternocleidomastoid muscle for treatment of torticollis”. Medical Journal of Cairo University 1 (2022): 299-304.
  58. Farzad Omidi-Kashani., et al. “Is surgery recommended in adults with neglected congenital muscular torticollis? A prospective study”. BMC Musculoskeletal Disorders 9 (2008): 158.
  59. Jaiswal CSS., et al. “Congenital muscular torticollis”. Medical Journal Armed Forces India3 (2005): 277-278.
  60. Shan J., et al. “The effectiveness of a novel surgical approach for the treatment of congenital muscular torticollis”. Medicine14 (2020): e19572.
  61. Akazawa H., et al. “Congenital muscular torticollis: long-term follow-up of thirty-eight partial resections of the sternocleidomastoid muscle”. Archives of Orthopaedic and Trauma Surgery 5 (1993): 205-209.
  62. Chen CE and Ko JY. “Surgical treatment of muscular torticollis for patients above 6 years of age”. Archives of Orthopaedic and Trauma Surgery3-4 (2000): 149-151.
  63. Amemiya M., et al. “Outcome of treatment for congenital muscular torticollis: a study on ages for treatment, treatment methods, and postoperative therapy”. European Journal of Orthopaedic Surgery and Traumatology 19 (2009): 303-307.
  64. Lepetsos P., et al. “Surgical management of congenital torticollis in children older than 7 years with an average 10-year follow-up”. Journal of Pediatric Orthopaedics B 6 (2017): 580-584.
  65. Sahu RL. “Results of minimally invasive bipolar tenotomy of congenital muscular torticollis”. Chilean Journal of Orthopaedics and Traumatology1 (2019).
  66. Cheng JCY and Tang SP. “Outcome of surgical treatment of congenital muscular torticollis”. Clinical Orthopedic and Related Research 362 (1999): 190-200.
  67. Panigrahi R., et al. “Management of neglected cases of congenital muscular torticollis with bipolar release”. International Journal of Research in Orthopaedics 4 (2016): 400-403.
  68. Ekici NY., et al. “Congenital muscular torticollis in older children: Treatment with z-plasty technique”. Journal of Craniofacial Surgery 5 (2014): 1867-1869.
  69. Kashani FO., et al. “Is surgery recommended in adults with neglected congenital muscular torticollis? A prospective study”. BMC Musculoskeletal Disorders 9 (2008): 158.

Nguyen Ngoc Hung., et al. "Long Time Outcome of Surgical Bipolar with Z-Plasty Lengthening and Postoperative with or without Place Cast for Congenital Muscular Torticollis". EC Paediatrics 12.12 (2024): 01-21.

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