Evaluation of the Results of Unipolar Release of Congenital Muscular Torticollis in Children

Abstract

Background: Congenital muscular torticollis (CMT) is a common congenital neck deformity that primarily involves the sternocleidomastoid muscle, causing the head to tilt and rotate. It affects 0.3-1.9% of live births. Objective: This study aims to evaluate the functional, cosmetic outcomes, and complications of distal unipolar release surgery in children with congenital muscular torticollis, assessing its effectiveness in managing the deformity. Methods: A quasi-experimental prospective study was conducted at Dhaka Medical College Hospital, NITOR, and BSMMU. Twelve patients, aged 5-12 years, with conservatively treated or untreated CMT, were included. Distal unipolar release of the sternocleidomastoid muscle was performed, followed by regular postoperative physiotherapy. The functional and cosmetic outcomes were evaluated using Lee et al.'s scoring system. Informed written consent was obtained from the parents, and patients were followed up for 3-18 months. Results: Among the 12 patients (2 boys and 10 girls), 8 had right-sided torticollis and 4 had left-sided. The average follow-up period was 12 months. Preoperative assessment showed a mean functional score of 6.5 out of 9. Postoperative assessment showed excellent and good results in 83.4% of cases (10/12 patients), with 7 patients achieving excellent outcomes and 3 showing good results. The mean postoperative score was 16.4 out of 18, demonstrating significant improvement in both function and cosmesis. Conclusion: Distal unipolar release is a simple and effective surgical method for correcting CMT in children, providing excellent functional outcomes and aesthetically acceptable scars. The procedure yields high success rates with minimal complications.