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Wryneck
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A condition characterized by a tilting of the head to one side due to a shortening of the neck muscles (sternocleidomastoid muscle).
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Torticollis occurs at birth or within
the first 2 months of life. The right side is commonly
affected
- Head tilts to one side
- Rotation of the face and chin to the opposite side
- Lump (sternocleidomastoid mass) or swelling may be seen in the affected neck muscles, which usually resolves itself by 3 months of age
- The head cannot be straightened due to a decreased range of motion in the neck muscles.
- Facial asymmetry occurs in cases of longstanding torticollis. The affected side of the face may become flat.
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The exact cause is uncertain, but there
are several theories.
- Birth trauma -- it is believed that torticollis occurs as a result of a stretching or a tear of the neck muscles during delivery. As the hematoma and swelling subside, a scar tissue forms within the muscle, causing the muscle to shorten.
- Abnormal position of the head in the uterus
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- History and physical examination.
- There are other conditions that result in torticollis, such as vertebral abnormalities or spinal cord abnormalities. If other causes of torticollis are suspected after a physical examination, additional examinations may be required such as X-Rays or MRI scans.
- Hip X-Rays or Ultrasound exams are needed because hip dysplasia can be present about in about 20% of the cases.
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- Stretching exercises of the neck muscles should be done 3 to 6 times a day.
- In young children, encourage head
turning to stretch the contracted muscles by using the
child's favorite toy to attract their attention.
Padding a car seat on the affected side
- If physical therapy doesn't work, then a surgical release of the contracted muscles may be required.
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Most of the torticollis is resolved with stretching exercises. Early diagnosis and treatment is important in avoiding permanent deformities.
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