OPERATIVE TREATMENT OF NEGLECTED CONGENITAL MUSCULAR TORTICOLLIS WITH BIPOLAR RELEASE WITHOUT Z-PLASTY IN CHILDREN OF 5-9 YEARS OF AGE

  • Arshad Bashir
  • Dr Qazi Waris Manzoor GMC srinagar
  • Bashir Ahmed Mir
Keywords: neglected, congenital muscular torticollis, bipolar release, no z-plasty

Abstract

Background: Congenital muscular torticollis (CMT) is the third most common congenital musculoskeletal anomaly with a reported incidence of 0.3–1.9% .With respect to the developing world like ours, neglected CMT is common as the cases are reported mostly late in childhood. We assessed the results of simple bipolar release without z-plasty for neglected CMT in eight children of five to nine years of age. Methodology: A small post auricular incision was made over the mastoid, the insertion of sternocleidomastoid (SCM) muscle located and freed. A 2 to 3 cm transverse second incision about two cm superior to the sternoclavicular joint was made; platysma, fascial fibrous bands and sternal and clavicular attachments of SCM were divided. Patients were put on a custom made brace from the next day and supervised physiotherapy was started as soon as pain permitted. Lee et al. scoring system was used to grade the result as excellent, good, fair or poor at final follow up. Results: The study had five boys and three girls with a mean age of 6.6 years (range 5 to 9 years). Six patients had right side and two had left sided involved. Four children had never sought treatment while the other four were non-complaint. The mean follow up period was 2.54 years (range 1 to 5 years). The results were excellent in three patients (37.5%), good in four patients (50%) and fair in one patient (12.5%).There was no poor result. Conclusion: Bipolar release without z-plasty is an effective and technically simple treatment for neglected CMT patients up to 9 years of age with minimal chances of complications.

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Published
2022-05-02
How to Cite
[1]
A. Bashir, D. Q. W. Manzoor, and B. Mir, “OPERATIVE TREATMENT OF NEGLECTED CONGENITAL MUSCULAR TORTICOLLIS WITH BIPOLAR RELEASE WITHOUT Z-PLASTY IN CHILDREN OF 5-9 YEARS OF AGE”, JSS, vol. 9, no. 1, May 2022.