- 723.5 Torticollis, unspecified
Torticollis Natural History / Etiology
- any deformity in which the head is tilted and abnormally rotated
- Congenital Muscular Torticollis=most common cause in infancy. Caused by contracture of the sternocleidomastoid muscle. Associated with metatarsus adductus, DDH, clubfoot.
- Childhood torticollis is commonly cause by Atlantoaxial rotatory displacement. (JBJS 1989; 71A)
- Persistent torticollis may lead to skull and facial deformities
Torticollis Differential Diagnosis
- congenital muscular torticollis
- osseous malformation
- Klippel-Feil syndrome
- posterior fossa tumor
- ocular dysfunction
- Grisel’s Syndrome, etc
- c-spine films to r/o bony abnormality
- consider CT if occurs ofter trauma and pt has normal xrays
- <1y/o=sternocleidomastoid muscle stretching. Stretch contralateral ear to the shoulder and gently push the chin to touch the shoulder on the same side as the contracture. 90% resolve with stretching.
- >2y/o=unipolar or bipolar sternocleidomastoid release.
- Lincoln, JAAOS 2003;11:312-320