Amaral Daniela M, Cadilha Rui P B S, Rocha José Afonso G M, Silva Ana Isabel G, Parada Fernando
Department of Physical and Rehabilitation Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal.
Porto Biomed J. 2019 Feb 2;4(3):e36. doi: 10.1097/j.pbj.0000000000000036. eCollection 2019 May-Jun.
The congenital muscular torticollis is characterized by a persistent lateral flexion of the head to the affected side and cervical rotation to the opposite side due to unilateral shortening of the sternocleidomastoid muscle. The majority of the cases resolve with conservative management, with parents/caregivers education and physical therapy.The aim of this study was to assess demographic and clinical characteristics, treatment options, and outcome, amongst infants referred to pediatric rehabilitation consultation due to congenital muscular torticollis.
Retrospective cohort study of infants diagnosed with congenital muscular torticollis between January 2012 and December 2014. Obstetric and perinatal data, clinical presentation, comorbidities, treatment, and outcome were abstracted from clinical records.
One hundred six infants were included. There was no sex predominance and mean age at first pediatric rehabilitation consultation was 11.6 (10.4) weeks. Most women were primiparous (76.4%), dystocic labor predominated (73.6%), and pelvic fetal presentation occurred in 20.8%. At examination, 49.1% of the infants had abnormalities, beyond the tilt cervical, mainly range of motion restrictions and palpable nodule in sternocleidomastoid muscle. Among the 87 children who performed the cervical ultrasound, 29 (27.4%) had anomalies. Associated clinical conditions such as hip dysplasia were identified. The majority (71.7%) were submitted to conservative treatment, 30.2% in the Pediatric Rehabilitation Department. Most infants (97.2%) showed a complete resolution of the torticollis.
Congenital muscular torticollis is the most common cause of torticollis in the infants. Early diagnosis, parent/caregivers education, and conservative treatment are crucial to achieving good results.
先天性肌性斜颈的特征是由于胸锁乳突肌单侧缩短，头部持续向患侧侧屈并向对侧旋转。大多数病例通过保守治疗、家长/照顾者教育和物理治疗得以解决。本研究的目的是评估因先天性肌性斜颈转诊至儿科康复门诊的婴儿的人口统计学和临床特征、治疗选择及治疗结果。
对2012年1月至2014年12月期间诊断为先天性肌性斜颈的婴儿进行回顾性队列研究。从临床记录中提取产科和围产期数据、临床表现、合并症、治疗及治疗结果。
共纳入106例婴儿。无性别优势，首次儿科康复门诊的平均年龄为11.6（10.4）周。大多数女性为初产妇（76.4%），难产占主导（73.6%），20.8%为臀位胎儿。检查时，49.1%的婴儿除颈部倾斜外还有异常，主要是活动范围受限和胸锁乳突肌可触及结节。在87例行颈部超声检查的儿童中，29例（27.4%）有异常。发现了诸如髋关节发育不良等相关临床情况。大多数（71.7%）接受了保守治疗，30.2%在儿科康复科接受治疗。大多数婴儿（97.2%）的斜颈完全消失。
先天性肌性斜颈是婴儿斜颈最常见的原因。早期诊断、家长/照顾者教育和保守治疗对取得良好效果至关重要。
