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Clinical characteristics and courses of congenital muscular torticollis

Korean Journal of Pediatrics 2009;52(11):1273-1278.
Published online November 15, 2009.
Clinical characteristics and courses of congenital muscular torticollis
Kyong Eun Choi1, Hee Chul Lee1, So Young Youn1, Jung Mi Chun1, Son Moon Shin1, Byung Hee Han2, Yong Taek 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
선천성 근육성 사경의 임상적 특징과 경과
최경은1, 이희철1, 윤소영1, 천정미1, 신손문1, 한병희2, 이용택3
1관동대학교 의과대학 제일병원 소아청소년과
2관동대학교 의과대학 제일병원 영상의학과
3강북삼성병원 재활의학과
Correspondence: 
Jung Mi 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.
Key Words: Torticollis, Obstetrical, Risk factors, Plagiocephaly


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