Torticollis - a pathological change in the bone and muscle in the neck, resulting in an incorrect statement of the head of an infant or older children. When torticollis head turned down sideways and can be turned to one side.
Due to the strain the neck as a result of growth and development, skeletal defects are formed and posture, broken a symmetrical head growth. Torticollis is one of the most common pathologies, is more common in girls, it may be considered as a variant of malformations.
Torticollis frequency ranks third among the congenital diseases of the musculoskeletal system after congenital clubfoot and congenital hip dislocation.
The most commonly observed form of muscle.
Kinds
There are two big types of torticollis:
- congenital, her baby is born originally,
- acquired, it occurs due to disturbances in the skeleton and muscle tone.
Depending on the anatomical landmarks and tissue affected with torticollis, stands out:
- dermatogenic (skin) form - the defeat touches the skin and subcutaneous tissue,
- desmogennaya - it is the result of inflammation in the neck (cellulitis, abscesses, lymphadenitis),
- myogenic - is the result of muscle damage,
- neurogenic torticollis - the defeat of the receptor of the neuromuscular system in violation of muscle tone, often - with its increase, although it may be hypotonic,
- arthrogenic form - develops in the affected joints in the cervical spine area,
- osteogenic torticollis - defeat osteoarticular apparatus, the formation of additional processes of the cervical vertebrae, the neck of false ribs, etc.
Causes
When forming the base damage torticollis feels special muscle - sternoclavicular-mastoid, it is involved in the processes of nodding his head, with pan, tilt.
In congenital muscular torticollis formed hypoplasia in utero and therefore - shortening the neck.
Also torticollis may develop due to improper installation and long head in utero, when a muscle is insufficient load is applied.
In the process of giving birth torticollis can be formed due to the damage muscles gross manipulations - sipping for the head, the vacuum extraction delivery in breech presentation with incorrect breeding and tilting head. In addition, torticollis can result in factors such as birth trauma muscles with her anguish, rupture, hemorrhage, ischemia, stretching. As a consequence the inflammatory process is formed.
After giving birth, the cause may be the constant lying on one side, in an uncomfortable bed.
The symptoms of torticollis
The first manifestations of muscular torticollis occur immediately after birth, and after 2-3 weeks, but they are often mild and can be detected only by experienced parents or orthopedic surgeon.
At the age of about 3 weeks in the neck area there is a significant thickening and compaction muscles (in the middle or lower third of the muscles on one side).
Fade torticollis will grow, at a palpation the muscles baby can wrinkle or capricious, attempts to turn heads in the opposite direction can cause weeping and the impossibility perform an action.
When expressed head injury occurs deviation in the direction of defeat with a turn face to the healthy muscle in a pathological head position is fixed.
Without adequate therapy, muscle compacted and shortened gradually atrophies. Formed skull defects with its anti-aliasing on the affected side, the asymmetry of the skull and abnormal head position. In severe lesions can be lifted shoulder on the affected side, varies eye on the affected side, deformation expressed facial and cranial sections.
The back-side formed cervical scoliosis, cranial asymmetry in the ear and neck muscle strain.
Diagnostics
diagnostic base - a thorough examination of the child orthopedist and visual assessment statement head, probing the muscles and its comparison with the healthy side, head to the desired setting position.
In order to carry out more diagnostic X-rays of the cervical spine, sometimes will be applied MRI of the cervical spine.
Treatment of muscular torticollis
Muscular torticollis in infants can be treated conservatively, because all the tissues and muscles more pliable, and can be pulled out and build muscle. In severe lesions, resulting in profound defects may require prompt correction methods.
Conservative treatment includes:
- conducting special pilings on its side for stretching the muscles due to the position,
- conducting special massages to enhance tone, activate blood circulation and relieve inflammation,
- application of special prosthetic, Schantz collars,
- solljuks lamps or heaters, electrophoresis,
- special provision for a child to sleep rolled up and planted under the back rollers and towels.
On average, torticollis persists for 5-6 months, gradually stretched muscle and compared with healthy.
Surgical treatment is indicated in children after 2 years, with heavy dermogennymi and muscle defects. Spend an artificial lengthening of the muscles with the further imposition of special structures and physical therapy, massage and exercises to develop and stretching muscles, raise the tone.
On average, for rehabilitation after surgery takes between 2 or more months.
The prognosis of torticollis
The prognosis for timely treatment favorable torticollis disappears without a trace. Without treatment, there is a strong deformation and asymmetry of the skull, shortening and degeneration of muscles, impaired spinal support function and disability.