Barry Mamadou M, Sarradin Thomas, Delpont Marion, Captier Guillaume
Department of Paediatric Orthopaedic and Plastic Surgery, CHU Montpellier, University of Montpellier, Montpellier, France.
J Craniofac Surg. 2025;36(5):1624-1627. doi: 10.1097/SCS.0000000000011346. Epub 2025 May 6.
Congenital muscular torticollis is the third most common cause of orthopedic deformity. It is a risk factor for plagiocephaly. Physiotherapy is the preferred treatment. However, if it fails, surgery is recommended. This study examined the surgical results of congenital muscular torticollis in association with age. A retrospective descriptive study of patients who underwent surgery (tenotomy of the sternocleidomastoid muscle) for congenital muscular torticollis at a single center between 2000 and 2022 was, accordingly, performed. Clinical results (excellent, good, or poor) were examined in the following 3 age groups: younger than 18 months, older than 4 years, and an intermediate age. Surgical results were evaluated for at least 12 months of follow-up. During the study period, 96 cases of congenital muscular torticollis were surgically treated, and 75 records met the inclusion criteria. Initial physiotherapy was administered to all patients for an average of 16.9 months. Excellent and good results were better in the below 18-month group (mean: 13.4 mo) without recurrence. The results were poor in 22.8% of intermediate-age patients and in 13.0% of those older than 4 years. Thus, surgery for congenital muscular torticollis, after the failure of physiotherapy, achieved an overall success rate of 85.6% (excellent or good). Bipolar tenotomy should, therefore, be performed if congenital muscular torticollis is resistant to physiotherapy. The optimal period is between 12 and 18 months of age. In cases of neglected torticollis, better results are obtained if surgery is postponed until after the child is 4 years old. Level of evidence: level III.
先天性肌性斜颈是整形外科畸形的第三大常见病因。它是扁头畸形的一个危险因素。物理治疗是首选治疗方法。然而，如果治疗失败，则建议进行手术。本研究探讨了先天性肌性斜颈的手术结果与年龄的关系。因此，对2000年至2022年期间在单一中心接受先天性肌性斜颈手术（胸锁乳突肌切断术）的患者进行了一项回顾性描述性研究。在以下3个年龄组中检查临床结果（优、良或差）：18个月以下、4岁以上和中间年龄组。对手术结果进行至少12个月的随访评估。在研究期间，96例先天性肌性斜颈患者接受了手术治疗，75份记录符合纳入标准。所有患者均接受了平均16.9个月的初始物理治疗。18个月以下组（平均：13.4个月）的优、良结果更好，且无复发。中间年龄组22.8%的患者和4岁以上组13.0%的患者结果较差。因此，物理治疗失败后，先天性肌性斜颈手术的总体成功率为85.6%（优或良）。因此，如果先天性肌性斜颈对物理治疗有抵抗性，应进行双侧切断术。最佳时期是12至18个月龄。在被忽视的斜颈病例中，如果将手术推迟到儿童4岁以后，则可获得更好的结果。证据级别：三级。
