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Monday, 27.03.2023, 03:23
Main » Traumatology » Congenital muscular torticollis 
Congenital muscular torticollis

Torticollis - this strain the neck, characterized by a wrong position of the head, where the head is tilted to the affected side and some to face in a healthy way. The causes of head tilt may be a violation of the normal state of bone, soft tissue, blood vessels or nerves. It is congenital and acquired.

Congenital muscular torticollis third in frequency of congenital disease of the musculoskeletal system. Suffer more girls. Usually develops torticollis to the right. The cause of congenital torticollis is most often pathology sternocleidomastoid (sternocleidomastoid) muscle. Sternocleidomastoid muscle located on both sides of the neck. On top of it is attached to the mastoid located behind and below the ear, attached to the bottom of the clavicle. The function of this muscle - tilt and rotate the head. It is believed that in the case of congenital torticollis is congenital malformation of the muscles combined with muscle injury during childbirth.

Injury is accompanied by hemorrhage into the muscle, then formed a scar and the muscle shortens. Immediately after birth Krivoshei identify possible less than 1% of cases. Only in some infants can detect thickening of the sternocleidomastoid muscle on one side or the asymmetry of the face. In the subsequent muscle from the patient side is lagging behind in growth of healthy. And in the third week of life becomes apparent inclination of the head in the affected side and turn the person into a healthy direction, but turning the head in this direction is difficult.

If you do not take measures to eliminate the torticollis, gradually increasing the child's facial asymmetry due to improper growth of facial muscles, and because of the forced position of the head. Cervical spine is curved. The orifice can be of different sizes and shapes. If Krivoshei not treated, it progresses gradually and reaches the age of 6-7 years marked changes. The baby's head is turned to the side, shoulder girdle elevated, the asymmetry of the face, skull, cervical spine. The eyes and eyebrows of the patient muscle are lower than on the healthy side. Violated the right development of the sky. Increases in the size of mastoid bone, which attaches to the sternocleidomastoid muscle. May change the normal direction of the ear canal. Very rare double-sided torticollis. In this case the patient's head is most often thrown back, sometimes leaning forward. Turns head sharply limited.

Other forms of torticollis are less common.

neurogenic form. Torticollis develops due to paralysis of the neck muscles. This may be spastic paralysis after suffering encephalitis. Then there are jerking of muscles (tikoidnye hyperkinesis - violent uncontrollable contractions of muscles) and sternocleidomastoid head movements. Flaccid paralysis after poliomyelitis may also lead to torticollis. The reason is the weakness of the neck muscles.

dermatogennaya (skin) form. In this form of torticollis develops as a result of scars formed after burns and trauma.
bone shape. Curvature of the neck is formed due to fusion of the cervical vertebrae (Klippel-feil disease), or wedge-shaped vertebrae.
desmogennaya form. By torticollis lead in this case inflammatory disease (inflammation of the lymph nodes, cellulitis) in the neck.
reflexive form of torticollis accompanied by inflammation of the middle ear, parotid gland, mandible.
traumatic torticollis develops after spinal injury (fractures and dislocations of the cervical vertebrae).

Treatment of congenital muscular torticollis. When detected early, prognosis is good torticollis. But with long-term absence of treatment, when the asymmetry of the skull has formed, to achieve good results is usually not possible. If torticollis is revealed in the hospital, the child is assigned a special styling while you sleep - healthy side of the wall, feeding so that the child tried to turn my head to the affected side, massage, sternocleidomastoid muscle on both sides.

After being discharged from the hospital appointed by physiotherapy, massage and physical therapy. Sometimes it is necessary to wear a collar-type Schanz, or a special cap. Most often, the end of the first year of life may be achieved disappearance of torticollis. If up to 2 years does not help, surgery is appointed. Performed plastic surgery on the affected muscle, after the operation is applied to cast 1.5 months. Over the next 6 months the patient must wear a special headholder different designs assigned physiotherapy and therapeutic exercise.

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