Outcome of surgical treatment of congenital muscular torticollis

Eighty-four patients with congenital muscular torticollis were treated surg ically in a 10-year period with a mean followup of 5 years (range, 2-13 gea rs). All patients mere classified into subgroups according to the type of c ongenital torticollis, the limitation of passive rotation of the neck, and other parameters, including head tilt and craniofacial asymmetry. Twenty-tw o (26.2%) patients underwent surgery before they were 1 year of age, 22.6% were between 1 and 3 years of age, 38.1% mere between 3 and 10 years, and 1 3.1% were older than 10 years, Postoperative management included physiother apy for 3 to 4 months and the application of a multiply adjustable torticol lis brace for 10 weeks in children older than 2 years of age, Loss of the s ternomastoid column was found in 82.6%, poor scar in 2.4%, lateral band in 47.2%, and 1.2% required a second operation, The final overall score showed excellent results in 88.1%, good results in 8.3%, and fair to poor results in 3.6%. The most important factor affecting the overall result and outcom e was found to be the age of the patient at the time of operation, However, this series also showed that for patients who were 10 years or older at th e time of surgery, 63.6% had excellent results and 81.8% had good to excell ent results, indicating the benefit of surgery even in the late cases.