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Outcome of surgical treatment for neglected congenital muscular torticollis: A series of 28 adolescent patients

BACKGROUND: Congenital muscular torticollis (CMT) is a common musculoskeletal anomaly that can be excellently managed at birth with conservative physiotherapy; as a result, literature on neglected cases of CMT in older patients is sparse, and there is controversy regarding the ideal surgical approac...

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Autores principales: Kamboh, Usman Ahmad, Ashraf, Mohammad, Zahra, Shah Gul, Raza, Muhammad Asif, Manzoor, Mehwish, Mehboob, Mehreen, Farooq, Minaam, Ahmad, Manzoor, Hussain, Syed Shahzad, Ashraf, Naveed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282755/
https://www.ncbi.nlm.nih.gov/pubmed/35855133
http://dx.doi.org/10.25259/SNI_314_2022
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author Kamboh, Usman Ahmad
Ashraf, Mohammad
Zahra, Shah Gul
Raza, Muhammad Asif
Manzoor, Mehwish
Mehboob, Mehreen
Farooq, Minaam
Ahmad, Manzoor
Hussain, Syed Shahzad
Ashraf, Naveed
author_facet Kamboh, Usman Ahmad
Ashraf, Mohammad
Zahra, Shah Gul
Raza, Muhammad Asif
Manzoor, Mehwish
Mehboob, Mehreen
Farooq, Minaam
Ahmad, Manzoor
Hussain, Syed Shahzad
Ashraf, Naveed
author_sort Kamboh, Usman Ahmad
collection PubMed
description BACKGROUND: Congenital muscular torticollis (CMT) is a common musculoskeletal anomaly that can be excellently managed at birth with conservative physiotherapy; as a result, literature on neglected cases of CMT in older patients is sparse, and there is controversy regarding the ideal surgical approach. This report aims to provide the outcome of 28 adolescent patients with neglected CMT who underwent unipolar release at the distal sternocleidomastoid muscle (SCM). METHODS: Twenty-eight adolescent patients with untreated CMT presented to our department between 2016 and 2019 and underwent unipolar release at the distal end of their SCM. All patients had no other anomaly based on clinical examination and radiological investigations. At the time of surgery, the mean age of patients was 15.8 years (range 13–18 years). There were 10 male and 18 female patients with the right side affected in 20 cases. All patients were followed up for 2 years. Patients were evaluated using an adapted version of the modified Lee’s scoring system to assess cosmesis and the cervical-mandibular angle (CMA) to assess radiological change. RESULTS: The adapted modified Lee’s scoring system indicated 17 patients (60.7%) had an excellent outcome, 6 patients (21.4%) had a good outcome, and 5 patients (17.9%) had a fair outcome. In particular, scarring was fine in 23 patients (82.1%) and only slight in the remaining. Independent to the categorical outcome, all patients subjectively reported high satisfaction with their cosmesis. The preoperative mean CMA was 19.6° (range, 8.5–31.5°), which was reduced to a mean of CMA of 14.0° (range, 3–28°) after surgery (P < 0.05). No patient developed any permanent complication or required surgery for recurrence. No serious postoperative complications such as infection or hematoma were observed. CONCLUSION: In uncomplicated cases of neglected CMT in adolescent patients, unipolar tenotomy of the distal SCM is a safe and reliable technique with good clinical outcomes.
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spelling pubmed-92827552022-07-18 Outcome of surgical treatment for neglected congenital muscular torticollis: A series of 28 adolescent patients Kamboh, Usman Ahmad Ashraf, Mohammad Zahra, Shah Gul Raza, Muhammad Asif Manzoor, Mehwish Mehboob, Mehreen Farooq, Minaam Ahmad, Manzoor Hussain, Syed Shahzad Ashraf, Naveed Surg Neurol Int Original Article BACKGROUND: Congenital muscular torticollis (CMT) is a common musculoskeletal anomaly that can be excellently managed at birth with conservative physiotherapy; as a result, literature on neglected cases of CMT in older patients is sparse, and there is controversy regarding the ideal surgical approach. This report aims to provide the outcome of 28 adolescent patients with neglected CMT who underwent unipolar release at the distal sternocleidomastoid muscle (SCM). METHODS: Twenty-eight adolescent patients with untreated CMT presented to our department between 2016 and 2019 and underwent unipolar release at the distal end of their SCM. All patients had no other anomaly based on clinical examination and radiological investigations. At the time of surgery, the mean age of patients was 15.8 years (range 13–18 years). There were 10 male and 18 female patients with the right side affected in 20 cases. All patients were followed up for 2 years. Patients were evaluated using an adapted version of the modified Lee’s scoring system to assess cosmesis and the cervical-mandibular angle (CMA) to assess radiological change. RESULTS: The adapted modified Lee’s scoring system indicated 17 patients (60.7%) had an excellent outcome, 6 patients (21.4%) had a good outcome, and 5 patients (17.9%) had a fair outcome. In particular, scarring was fine in 23 patients (82.1%) and only slight in the remaining. Independent to the categorical outcome, all patients subjectively reported high satisfaction with their cosmesis. The preoperative mean CMA was 19.6° (range, 8.5–31.5°), which was reduced to a mean of CMA of 14.0° (range, 3–28°) after surgery (P < 0.05). No patient developed any permanent complication or required surgery for recurrence. No serious postoperative complications such as infection or hematoma were observed. CONCLUSION: In uncomplicated cases of neglected CMT in adolescent patients, unipolar tenotomy of the distal SCM is a safe and reliable technique with good clinical outcomes. Scientific Scholar 2022-07-08 /pmc/articles/PMC9282755/ /pubmed/35855133 http://dx.doi.org/10.25259/SNI_314_2022 Text en Copyright: © 2022 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kamboh, Usman Ahmad
Ashraf, Mohammad
Zahra, Shah Gul
Raza, Muhammad Asif
Manzoor, Mehwish
Mehboob, Mehreen
Farooq, Minaam
Ahmad, Manzoor
Hussain, Syed Shahzad
Ashraf, Naveed
Outcome of surgical treatment for neglected congenital muscular torticollis: A series of 28 adolescent patients
title Outcome of surgical treatment for neglected congenital muscular torticollis: A series of 28 adolescent patients
title_full Outcome of surgical treatment for neglected congenital muscular torticollis: A series of 28 adolescent patients
title_fullStr Outcome of surgical treatment for neglected congenital muscular torticollis: A series of 28 adolescent patients
title_full_unstemmed Outcome of surgical treatment for neglected congenital muscular torticollis: A series of 28 adolescent patients
title_short Outcome of surgical treatment for neglected congenital muscular torticollis: A series of 28 adolescent patients
title_sort outcome of surgical treatment for neglected congenital muscular torticollis: a series of 28 adolescent patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282755/
https://www.ncbi.nlm.nih.gov/pubmed/35855133
http://dx.doi.org/10.25259/SNI_314_2022
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