Review article
https://doi.org/10.21751/FRM-38-3-4-3
HABILITATION OF CONGENITAL MUSCULAR TORTICOLLIS – CASE REPORTS
Valentina Matijević
orcid.org/0000-0003-0096-2034
Anamarija Jukić
Jelena Marunica Karšaj
orcid.org/0009-0007-7964-7673
*
* Corresponding author.
Abstract
Torticollis is a congenital or acquired tilted head position accompanied by an increased tone of the sternocleidomastoid muscle (SCM) with limited neck mobility. Characteristically, the head is flexed towards the shortened SCM, while the face is rotated to the opposite side. Following foot deformities and hip dysplasia, it is one of the three most prevalent locomotor deformities. Exercises are performed as a type of habilitation, other options include botulinum toxin injections, neck orthoses, and surgery. The most significant determinants of treatment duration and outcome are the age at the beginning of treatment and the intensity of habilitation. We present two cases of torticollis. In the first: a female child delivered in a breech position at 38 weeks via emergency section from a first normal-course pregnancy. The pediatric physiatrist revealed left-sided torticollis at the age of six weeks and referred to habilitation in outpatient settings and throughout the daycare hospital. Parents carried out the exercises at home for more than one hour daily. The resolution of malposition was accomplished at nine months and ten days; lateral flexion and neck rotation were within normal range. In the second: a male child delivered vaginally at term from a first pregnancy complicated by minor bleeding. On the 14th day of life, hyperechoic changes in the right SCM were verified by an ultrasound. After examining the child at five weeks of age, the pediatric physiatrist recommended habilitation of the same modality and dynamics. However, parents carried out the exercises for less than one hour. At two years and four months, the asymmetrical head position persists, although with milder expression. In conclusion, in addition to habilitation in outpatient settings and through the day-care hospital, it is necessary to perform exercises multiple times daily at home to achieve the optimal outcome sooner.
Keywords
torticollis, child, habilitation, parents, duration, outcome
Hrčak ID:
323105
URI
Publication date:
2.12.2024.
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