title: Arthroscopic surgical treatment for neglected congenital muscular torticollis in adults.
abstract: BACKGROUND
  Congenital muscular torticollis (CMT) is the third most common congenital musculoskeletal anomaly. The efficacy of surgical treatment of neglected CMT after skeletal maturity in adults remains controversial. The aim of this retrospective study was to determine the efficacy of arthroscopic release of the sternocleidomastoid (SCM) muscle for the treatment of neglected CMT in adult cases.
  
  
  METHODS
  From April 2008 to July 2013, a total of 20 adult patients (9 men and 11 women) with a mean age of 23.0 years were surgically treated for neglected CMT with local anesthesia. The SCM muscle and clavicle were preoperatively marked. Through an artificial lacuna, an arthroscope and a radiofrequency probe were inserted. The sternal and clavicular attachments were dissected and divided via radiofrequency. Clinical evaluation was assessed using a modified Cheng and Tang score.
  
  
  RESULTS
  The operation was successfully completed in all the patients. Follow-up examinations from 12 to 40 months in the 20 patients showed complete muscular release and satisfactory cosmetic appearance with no recurrence. There was no evidence of serious complications. The neck scars were no longer visible after several weeks. According to the modified Cheng and Tang scale, 11 patients displayed an excellent result and 9 patients had a good result.
  
  
  CONCLUSIONS
  Arthroscopic release of the SCM muscle with local anesthesia is a simple and effective way to surgically manage neglected CMT without any risk for either damage to the neurovascular structures or leaving visible scars.
authors: From the *Department of Orthopedics, Chinese People's Liberation Army General Hospital, Beijing; and †Medical School of Nankai University, Tianjin, China.
authors: Bangtuo
authors: B
authors: Yuan
authors: Feng
authors: F
authors: Qu
authors: Gang
authors: G
authors: Zhao
authors: Jiangtao
authors: J
authors: Wang
authors: Xuezhen
authors: X
authors: Shen
authors: Yujie
authors: Y
authors: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000772:Anesthesia, Local; D001182:Arthroscopy / Q000379:methods*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D009334:Neck Muscles / Q000601:surgery*; D012189:Retrospective Studies; D061665:Time-to-Treatment; D014103:Torticollis / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult