[Cap brace: a new treatment for newborn and infant congenital muscular torticollis].
Herein is reported a new treatment, using a cap brace, for congenital muscular torticollis (CMT) in newborn and infant. The subjects consisted of 72 cases undergoing cap brace treatment (CB-group), and 197 cases undergoing ordinary treatment (O-group) for CMT. In children of the O-group, the rolling-over developmental stage was later than in normal infants, while in those of the CB-group this stage was not delayed. The good prognostic factors for lessening cranial and facial asymmetry, evaluated by chi-square test, were as follows: partus praematurus, a high APGAR score, breast-feeding, an early start to rolling-over, early vanishing of the sternomastoid tumor, and early vanishing of limitation of neck movement. For discriminant analysis of the factors related to cranial and facial asymmetry, the quantification method of the second type was used. In the O-group, discrimination between asymmetry and no asymmetry was achieved (R = 0.832), but in the CB-group the factors involved could not be discriminated. Moreover, ultratomosonography was very useful for examining the sternomastoid muscle. The internal echogenicity changed from low to high with aging, and was the echo pattern was classified as types I to IV accordingly. Patients with an early change from type I to type II tended to show good results in cranial and facial asymmetry. This brace was developed with an improvement of the other similar braces. But unlike other devices our brace did not fix the infant's head in one position for correction. And as a result of this virtue, the sternomastoid muscle of the affected side was relaxed and the vanishing periods of asymmetrical tonic neck reflex are hastened. Use of this brace improved the cure rate and was especially effective in decreasing cranial and facial asymmetry.
Sakamoto
H
H
Department of Orthopedic Surgery, Toho University School of Medicine, Tokyo, Japan.
D000367:Age Factors; D001915:Braces; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009068:Movement; D009132:Muscles / Q000000981:diagnostic imaging; D009333:Neck; D014103:Torticollis / Q000151:congenital / Q000000981:diagnostic imaging / Q000628:therapy*; D014463:Ultrasonography