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Postsurgical Physical Therapy Management of Congenital Muscular Torticollis

Oledzka, Magdalena PT, DPT, MBA, PCS; Suhr, Maureen PT, DPT, PCS

doi: 10.1097/PEP.0000000000000375
Case Reports

Purpose: To present 2 cases with severe congenital muscular torticollis and describe postsurgical physical therapy management.

Description: Two children diagnosed with severe congenital muscular torticollis underwent surgical release of the involved sternocleidomastoid muscle with subsequent physical therapy. Presurgical examination findings, surgical technique, and postsurgical rehabilitation guidelines are described.

Results: Both cases achieved full range of motion and symmetrical muscle strength. Functionally, they were able to maintain consistent midline posture, perform transitions with symmetrical head righting, and demonstrate age-appropriate motor skills.

Clinical Implications: Children with surgical management of congenital muscular torticollis tend to have more severe involvement of the sternocleidomastoid. Prolonged experience in atypical postures may result in potential asymmetrical development of visual, vestibular, and proprioceptive systems. Perception of midline was reestablished through integration of visual, vestibular, and proprioceptive stimuli.

Video Abstract: For more insights from the authors, access Supplemental Digital Content 1, at http://links.lww.com/PPT/A141.

This case report provides 2 cases of post-surgical management of severe congenital muscular torticollis from inpatient acute care to outpatient functional rehabilitation 24 weeks postsurgery.

Pediatric Rehabilitation, Hospital for Special Surgery, New York.

Correspondence: Magdalena Oledzka, PT, DPT, MBA, PCS, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021 (oledzkam@hss.edu).

At the time the article was written, Magdalena Oledzka was a DPT student at Rocky Mountain University of Health Professions, Provo, Utah.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.pedpt.com)

The authors declare no conflicts of interest.

Copyright © 2017 Wolters Kluwer Health, Inc. and Section on Pediatrics of the American Physical Therapy Association. All rights reserved.