Congenital torticollis
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Definition/Description
Congenital torticollis or wry neck is a condition in infants detected at birth or shortly afterCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. It is characterized by rotational deformity of the cervical spine with secondary tilting of the head Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. There is a lateral head tilt to one side and contralateral rotationCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title[1]. It is most commonly the result of unilateral shortening and thickening or excessive contraction of the sternocleidomastoid muscle Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. The basic abnormality is known as endomysial fibrosis with deposition of collagen and migration of fibroblasts around individual muscle fibersCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. It leads to a limitation of the head mobility in both rotation and lateral flexion and progressive degrees of neck contractureCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Clinically Relevant Anatomy[edit | edit source]
The normal physiologic range of rotation of the atlas on the axis is 25o-53o degrees to either side. The transverse ligament is the primary stabilizer of the atlantoaxial joint and prevents excessive anterior motion of the atlas on the axis. It extends behind the dens, between the medial portions of the lateral masses of C1Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. The paired alar ligaments act as secondary stabilizers to prevent anterior shift. The alar ligaments extend from the lateral aspect of the dens tip to the medial aspect of the occipital condyles, with a lower portion attaching to the medial aspect of the lateral masses of C1Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
The sternocleidomastoid muscle has a sternal and clavicular head. The sternal head is directed from the manubrium sterni superiorly, laterally and posteriorly and the clavicular from the medial third of the clavicle vertically upward. It runs to the mastoid process. It enables an ipsilateral lateral flexion and a contralateral rotation. The muscle extends the upper part of the cervical spine and flexes the lower partCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
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References[edit | edit source]
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- ↑ Petronic I., et al. Congenital muscular torticollis in children: distribution, treatment duration and outcome. European Journal of Physical and Rehabilitation Medicine. 2010; 45(2): 153-158 (Level of Evidence 2)
