Previous Post: Congenital torticollis- Diagnosis and Assessment
Management of Congenital Torticollis
Investigations
- Routine neck imaging is not recommended
- If a mass is present but not characteristic of SCM, ultrasound (US) may be helpful
- A cervical spine X-ray may detect vertebral anomalies in atypical torticollis
- A hip US in infants with congenital muscular torticollis is recommended
Treatment
- Educate caregiver on infant positioning during feeding, sleeping and playing (including the importance of supervised prone positioning) and making environmental modifications to encourage head and neck movement
- Passive stretching exercises 4-5 times a day
- Follow up within 4 weeks for monitoring
- Consider referral to physiotherapy in the following cases:
- No improvement with home exercises by 4-6 weeks
- Severe torticollis: limited ROM at diagnosis (e.g. <30 degrees rotation)
- Child older than 3 months at diagnosis with more than minimal torticollis
- Associated moderate to severe plagiocephaly
A majority of cases will resolve after four to five months. If no significant improvement by 6 months of age, re-consider the diagnosis or refer to paediatric orthopaedic surgeon.
Previous Post: Congenital torticollis- Diagnosis and Assessment
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