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. 2023 Jun;35(3-4):188-194.
doi: 10.1007/s00064-023-00805-x. Epub 2023 Apr 20.

[Surgical treatment of congenital muscular torticollis]

[Article in German]
Milena M Ploeger  1 , Christoph Trillhaase  2 , Charlotte Rommelspacher  2 , Rahel Bornemann  2 , Robert Ossendorf  2 , Richard Placzek  2
Affiliations

[Surgical treatment of congenital muscular torticollis]

[Article in German]
Milena M Ploeger et al. Oper Orthop Traumatol. 2023 Jun.

Abstract
in English, German

Objective: Surgical treatment of congenital muscular torticollis with tripolar release of the sternocleidomastoid muscle, followed by modified postoperative treatment with a special orthosis.

Indications: Muscular torticollis due to contracture of the sternocleidomastoid muscle; failure of conservative therapy.

Contraindications: Torticollis due to bony anomaly or other muscular contractures.

Surgical technique: Tenotomy of the sternocleidomastoid muscle occipitally and resection of at least 1 cm of the tendon at the sternal and clavicular origin.

Postoperative management: Orthosis must be worn for 6 weeks 24 h/day, then for another 6 weeks 12 h/day.

Results: A total of 13 patients were treated with tripolar release of the sternocleidomastoid muscle and modified postoperative management. Average follow-up time was 25.7 months. One patient presented with recurrence after 3 years. No intra- or postoperative complications were observed.

Zusammenfassung: OPERATIONSZIEL: Operative Korrektur des Torticollis muscularis congenitus (TMC) mit triterminaler Tenotomie des M. sternocleidomastoideus (SCM) sowie postoperativer Behandlung in der Spiegel-Orthese.

Indikationen: Muskulär bedingter Torticollis im Rahmen einer Kontraktur des SCM, nach Versagen der konservativen Therapie ab dem 2. Lebensjahr.

Kontraindikationen: Torticollis im Rahmen einer ossären Anomalie oder aufgrund anderer muskulärer Kontrakturen OPERATIONSTECHNIK: Durchtrennung des M. sternocleidomastoideus (SCM) am Ursprung und Ansatz (klavikulär und sternal) mit Resektion der Sehne von ca. 1 cm im Bereich des Ansatzes.

Weiterbehandlung: Postoperative Anlage der Spiegel-Orthese. Tragen der Orthese 24 h/Tag für die ersten 6 Wochen postoperativ, danach Tragen der Orthese 12 h/Tag für weitere 6 Wochen.

Ergebnisse: Operiert wurden n = 13 Patienten mit TMC. Das Follow-up betrug im Durchschnitt 25,7 Monate, bei 1 Patienten kam es nach 3 Jahren zu einem Rezidiv. Weder intra- noch postoperative Komplikationen wurden beobachtet.

Keywords: Congenital muscular torticollis; Orthotic devices; Torticollis therapy; Tripolar tenotomy.

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