Congenital muscular torticollis: Early and intensive treatment is critical. A prospective study

Background: Although the success of conservative management of congenital m uscular torticollis has been well documented, relatively little is known ab out the determinants of this outcome, such as treatment duration and exerci se frequency. The aim of the present study was to define factors related to treatment duration, to compare different frequencies and intensities of ho me treatment programs and their effect on the speed of recovery. Methods: The present study was a prospective study of 45 infants (26 male, 19 female) with congenital muscular torticollis referred to the pediatric s urgical outpatient during a 1 year period. Following a standardized initial assessment, parents were taught our intensive home treatment protocol, con sisting of passive stretching exercises repeated every 3 h. Results: The mean age at initial assessment was 38.6 days (range 15-120 day s). Mean treatment duration was found to be 3.2+/-1.3 months. All patients were treated by use of our intensive protocol of passive stretching exercis es (100% success). No surgery was necessary. Conclusions: In patients with early treated congenital muscular torticollis , there is no place for surgical treatment. This group of patients can be s uccessfully treated using an intensive protocol of passive stretching exerc ises. In addition, this treatment protocol has a very short treatment durat ion compared with other standardized protocols. A successful outcome depend s primarily on good cooperation with the parents, especially in developing countries.