Research Article Open Access Angoules et al., J Gen Pract 2013, 1:1 http://dx.doi.org/10.4172/2329-9126.1000105 Review Article Open Access General Practice Volume 1 • Issue 1 • 1000105 J Gen Pract ISSN: 2329-9126 JGPR, an open access journal Keywords: Congenital muscular torticollis; Treatment; Manual stretching; Tenotomy; Allantoin toxine Introduction Congenital Muscular Torticollis (CMT) is a congenital deformity characterized by unilateral shortening of the sternocleidomastoid muscle resulting in lateral inclination of the neck associated with contralateral torsion [1] (Figure 1). he typical clinical element is a irm mass sized between 1 to 3 cm which causes shortening of the sternocleidomastoid and it is normally palpable at 1 to 4 weeks of age [2]. Although this lesion has been considered as an hematoma formation, the presence of hemosiderin has not been revealed in pathological specimens of excised masses and additionally ultrasonography, and Computerized Tomography oten record isoechoic or homogeneous indings [3]. Most of cases resolve within the irst year ater birth. Nevertheless this irm still painless ibrotic tissue in severe cases subsequently results in secondary plagiocephaly and skull and facial asymmetry [4-7]. It is a relatively common recognized infantile abnormality and its incidence varies from 0.3% to 2.0% live births [2]. CMT is recorded as is the third most common congenital musculoskeletal anomaly ater dislocation of the hip and clubfoot [1,5]. CMT is oten associated with other congenital deformities such as Developmental Dysplasia of the Hip (DDH) with a coexistence rate estimated as high as 14.9% [8]. Other coincident lesions less frequently recorded include tibial torsion, clubfoot, calcaneovalgus foot, lexible pes planus, metatarsus adductus, and hallux valgus [9]. Aetiology Although evidence about CTM aetiology is vague it is postulated that fetal position abnormalities, intrauterine or perinatal compartment syndrome and birth trauma ensuing a diicult delivery embody the main causes [5,10]. Other possible causes encountered are hereditary and venous or arterial occlusion which may create ibrous tissue within the sternocleidomastoid [6,11]. Diagnosis Diagnosis is based mainly on past medical history and clinical examination of the infant. A meticulous prenatal history record is essential and detects complicated labor and the coexistence of previous birth trauma such as clavicular fracture. he presence of perinatal asphyxia, jaundice, seizures, medication, gastroesophageal relux disease (GERD) or Sandifer’s syndrome are also recorded [12]. A irm painless not tender pseudotumor mass is typically palpable in the irst few weeks of life [3,13]. his lump can afect both the sternal and clavicular parts of the muscle [14]. his endomysial mass is consisted of ibrotic issue linked with deposition of collagen and migration of ibroblasts around the atrophic sternocleidomastoid ibers [5]. Clinical examination includes evaluation of neck range of motion, and thorough neurological assessment. *Corresponding author: Antonios G Angoules, General Department of Essential Medical Subjects, Technological Educational Institute of Athens, Greece, E-mail: antoniosangoules@yahoo.com Received April 30, 2013; Accepted May 13, 2013; Published May 17, 2013 Citation: Angoules AG, Boutsikari EC, Latanioti EP (2013) Congenital Muscular Torticollis: An Overview. J Gen Pract 1: 105. doi: 10.4172/2329-9126.1000105 Copyright: © 2013 Angoules AG, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Congenital Muscular Torticollis (CMT) is a congenital deformity characterized by unilateral shortening of the sternocleidomastoid muscle resulting in lateral inclination of the neck associated with contralateral torsion. It is a relatively common infantile deformity associated with typically favourable prognosis when early detected and treated. Although stretching exercises is still the most common treatment, this therapeutic approach should be applied early in younger subjects to be eficient. Surgical intervention is guaranteed before an established craniofacial asymmetry. The purpose of this is to provide an overview of the current therapeutic approaches with additional analysis of their effectiveness. Congenital Muscular Torticollis: An Overview Antonios G Angoules 1 *, Eleni C Boutsikari 2 and Eleni P Latanioti 3 1 General Department of Essential Medical Subjects, Technological Educational Institute of Athens, Greece 2 Department of Physical Therapy, Technological Educational Institute of Athens, Greece 3 Physical Therapist, Athens, Greece Figure 1: A contracted sternocleidomastoid muscle can be palpated in a girl with CMT. (Courtesy of Gkiokas Andreas MD, PhD, 1 st Orthopaedic Department, General Children’s Hospital, ‘P. & A. Kyriakou’, Athens, Greece).