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Comparison of Clinical Findings of Congenital Muscular Torticollis Between Patients With and Without Sternocleidomastoid Lesions as Determined by Ultrasonography

Han, Mi-Hyang, MD*; Kang, Jin Young, MD, PhD; Do, Hyun Jung, MD*; Park, Hyun Suk, PT*; Noh, Hyun Jin, PT*; Cho, Yun-Hwa, PhD; Jang, Dae-Hyun, MD, PhD*

Journal of Pediatric Orthopaedics: May/June 2019 - Volume 39 - Issue 5 - p 226–231
doi: 10.1097/BPO.0000000000001039
Cervical Spine

Aim: To compare clinical findings for patients with congenital muscular torticollis (CMT) between those with and without a sternocleidomastoid (SCM) lesion.

Methods: Medical records of 182 patients with CMT were retrospectively reviewed and the patients were divided into SCM lesion and nonlesion groups by ultrasonographic results. Intrauterine position, age, duration of therapy, rotation/tilting side, and the passive range of motion and angle of the neck were compared.

Results: There were 74 SCM lesion and 108 nonlesion cases. The mean age at the first visit was 55.3 days in the SCM lesion group and 146.6 days in the nonlesion group. The mean therapy time in the nonlesion group was 66.5 days, significantly shorter than for the SCM lesion group (117.5 d). Tilting and rotation of the head in the same direction was observed only in the nonlesion group (n=9, 8.3%). Rotational limitation of the affected muscle side was 22.6 degree in the SCM lesion and 3.6 degree in the nonlesion group, and the tilting limitation was 19.2 degree in the SCM lesion and 10.4 degree in the nonlesion group.

Conclusions: The nonlesion group had a better prognosis with shorter treatment duration. This group was more limited in head tilting than in head rotation, and the pattern of head rotation/tilting in the same direction was observed only in this group. These findings suggest that pathophysiological mechanisms and clinical characteristics may differ between CMT patients with and without SCM lesions.

Level of Evidence: Level II—prognostic studies, retrospective study.

*Department of Rehabilitation, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea

Seoul Asan Rehabilitation Clinic, Incheon

Korea Disabled People’s Development Institute, Seoul, Korea

The authors declare no conflicts of interest.

Reprints: Dae-Hyun Jang, MD, PhD, Department of Rehabilitation Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyeong-gu, Incheon 403-720, Korea. E-mail:

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