The goal of surgery in congenital muscular torticollis is to cut and then reattach the SCM muscle in a way that will remove the constricting bands of fibrous tissue, improve range of motion, and allow the head to be held vertically.
Symptoms of congenital torticollis are a painless mass on the neck appearing during the first two months of life and a persistent tilt of the head to one side for no other apparent reason.
In rare cases, congenital torticollis can also be a symptom of other congenital disorders including abnormalities of the neck vertebra such as spina bifida or Arnold-Chiari syndrome.
There is no sure way to prevent wryneck and congenital torticollis; however, care should be taken to avoid as much trauma to the child as possible during delivery.
Surgery is highly successful on children who do not respond to conservative treatment, so long as their torticollis is caused by restriction of the SCM muscle.
When congenital torticollis is caused by deformities of the neck bones (vertebrae), conservative treatment involves the use of neck braces or body jackets.
In cases where torticollis is caused by or complicated by bone deformities or other congenital defects, the outcome is less likely to be successful.
Support for this theory comes from the observation that children with congenital torticollis are often breech or difficult forceps deliveries.
For reasons that are not understood, about 20 percent of children with congenital muscular torticollis also have congenital hip dysplasia.
Parents' concerns often are focused on the psychological impact of torticollis in children who do to respond completely to treatment.