Chotigavanichaya C, Phongprapapan P, Wongcharoenwatana J, Eamsobhana P, Ariyawatkul T, Kaewpornsawan K
Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
Malays Orthop J. 2021 Mar;15(1):43-47. doi: 10.5704/MOJ.2103.007.
Congenital muscular torticollis (CMT), primarily resulting from unilateral shortening and fibrosis of the sternocleidomastoid muscle. One of the common surgical complications is recurrent deformity. However, the associations between unipolar or bipolar release, age of the patient, and the recurrence of the disease are unclear. Therefore, the purpose of this study was to evaluate the factors associated with recurrence after surgery.
A retrospective review was performed in 47 patients who were diagnosed with CMT and had been treated surgically with unipolar or bipolar release between January 2007 and December 2015. Demographic data (sex, sides, surgical technique, age at time of surgery, period of follow-up, complications and recurrence) were recorded.
Forty-seven patients with an average age of 8.7 years old at time of surgery. Twenty-six patients had right-sided muscular torticollis, while 21 had left-sided. The average follow-up time was 2 years (range, 2-4 years). The average age of unipolar release was 8.8 years old (range, 218 years old), while the average age of bipolar release was 8.7 years old (range, 2-13 years old). Recurrence occurred in 11 patients (9 in unipolar and 2 in bipolar release). Sex, side of deformity, type of surgery and age at time of surgery showed no statistically significant as a factor for recurrence rate, however recurrence of unipolar more than bipolar surgery was nearly two times revealing clinical significance.
Sex, side of deformity, type of surgery and age at time of surgery were not associated with the recurrence deformity.
先天性肌性斜颈(CMT)主要是由胸锁乳突肌单侧缩短和纤维化引起。常见的手术并发症之一是畸形复发。然而,单极或双极松解术、患者年龄与疾病复发之间的关联尚不清楚。因此,本研究的目的是评估与术后复发相关的因素。
对2007年1月至2015年12月期间诊断为CMT并接受单极或双极松解术治疗的47例患者进行回顾性研究。记录人口统计学数据(性别、患侧、手术技术、手术时年龄、随访时间、并发症和复发情况)。
47例患者手术时平均年龄为8.7岁。26例患者为右侧肌性斜颈,21例为左侧。平均随访时间为2年(范围2 - 4年)。单极松解术患者的平均年龄为8.8岁(范围2 - 18岁),双极松解术患者的平均年龄为8.7岁(范围2 - 13岁)。11例患者出现复发(单极松解术9例,双极松解术2例)。性别、畸形侧、手术类型和手术时年龄作为复发率的因素无统计学意义,然而单极松解术复发率比双极松解术几乎高两倍,具有临床意义。
性别、畸形侧、手术类型和手术时年龄与复发畸形无关。