Kirurgisk behandling av medfödt muskulaer torticollis. Når skal vi henvise?
Sammanfattning
Aim: The aim of the study was to evaluate our results of treatment and to improve
treatment and referral practices regarding congenital muscular torticollis (CMT) among
physiotherapists.
Design: Children operated for congenital muscular torticollis (CMT) were clinically reviewed
to evaluate satisfaction, function, cosmetics and quality of life..
Methods: 16 operated children were included from a cohort of 24 and examined in
average 4 years postoperatively. Active and passive range of motion, strength and
endurance was measured by two physiotherapists. Cheng score was used to rate functional
and cosmetic parameters, and the Pediatric Quality of Life Initiative (PedsQL) was
used to assess quality of life.
Results: Fourteen of 16 patients were satisfied and perceived a high quality of life.
Neck movement and muscle strength was close to normal at the follow-up. Fifteen of
16 patients still had some facial asymmetry. The results were independent of age. Our
results are consistent with other studies.
Conclusions: Current guidelines recommend early surgery. To counteract persistent
malposition and facial asymmetry, psychological distress and unnecessary use of time
and resources, these children should be referred to surgery when conservative treatment
is unsuccessful within the first year of life.