Congenital Torticollis

Excerpt

The clinical term "torticollis" comes from two Latin words: tortum collum, which means twisted neck. Usually, torticollis is not a diagnosis but rather a manifestation of a variety of underlying conditions. It can result from congenital or acquired causes. It can occur at any age, depending on the etiology.

Congenital torticollis is defined as a contracture or fibrosis of the Sternocleidomastoid muscle, on one side, leading to a homolateral inclination and contralateral rotation of the face and chin. Congenital torticollis usually manifests in the neonatal period or after birth. The worldwide incidence rate of congenital torticollis varies between 0.3% and 1.9%, other studies indicate a ratio of 1 per 250 newborns being the third congenital orthopedic anomaly, more frequently following congenital hip dysplasia and the calcaneovalgus feet.[5] Congenital torticollis may be accompanied by congenital hip dysplasia in an incidence of up to 20%. There is a male to female predominance with a 3 to 2 ratio, and it is more common to the right side. The diagnostic basis is usually on physical exam findings. This condition requires differentiation from other forms of congenital or acquired torticollis. Congenital torticollis is the primary condition of the muscle, which is detected at birth or in the first weeks of life. The acquired torticollis are, for example, congenital skeletal anomalies, traumatic conditions, infections, inflammation of adjacent structures, tumoral conditions, ocular, and neurological dystonias. The mainstay of treatment is physical therapy. Surgical management is necessary when physical therapy fails to provide results or for cosmetic reasons.