Rehabilitation in congenital muscular torticollis operated with Z-plasty: A case report

Abstract

Among the musculoskeletal congenital anomalies, congenital muscular torticollis (CMT) is the third most common. This condition presents with fibrosis of sternocleidomastoid muscle with increased lateral flexion on the same side and rotation on the opposite side. The objectives of the study were to reduce cervical deformity, mild facial asymmetry and to improve the range of motion of cervical lateral flexion and rotation. A 5-year-old female child had right torticollis for which she underwent Z-plasty. Evaluations were done on preoperative, postoperative day 1, 1 month, 4 months, and 7 months. Rehabilitation techniques included gradual stretching of the sternocleidomastoid muscle, splintage (static serial), positioning techniques, and play activities. Outcome measures observed were significant improvement in the posture of head tilt, range of motion using cervical goniometer, and facial asymmetry using photographs. This case report describes the importance of multidisciplinary treatment approach involving surgery, exercise therapy, play, and customized static serial splinting in the rehabilitation of CMT.