Outcome of bipolar release of the sternocleidomastoid muscle in neglected congenital muscular torticollis

Abstract

Purpose: Neglected congenital muscular torticollis (CMT) is a common presentation in our country, which poses largely a cosmetic disability. Surgical correction is recommended for patients with late reporting cases. The aim of this study is to evaluate the efficacy of surgical release of CMT in neglected cases. Materials and Methods: In the present retrospective case series, eleven patients of neglected CMT were treated by a modified Ferkel's release which comprising a bipolar release of the sternocleidomastoid muscle with Z-lengthening. The age at operation ranged from 4 to 18 years (mean 8.3 years). Post-operative protocol included head halter traction for 6 weeks and physiotherapy. Results were evaluated by the scoring system of Lee et al . Results: At an average follow-up of 4.4 years (range: 2-8.6 years), excellent results were noted in 8 patients (72.7%) and good in 3 (27.2%). In this study, significant improvement of neck motion, head tilt, chin deviation and cosmesis were observed with surgical treatment. There were no surgery-related complications or recurrences occurred in any of these patients. Conclusions: Patients with neglected CMT can benefit from surgical treatment and bipolar release is an effective and complication-free method for such patients.