Biterminal tenotomy for the treatment of congenital muscular torticollis

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Long-term results. Wirth-C-J. Hagena-F-W. Wuelker-N. Siebert-W-E. Orthopaedic Department, Hannover Medical School, Germany. [1mJ-Bone-Joint-Surg- [m[Am]. 1992 [1mMar [m. 74(3). P 427-34. Fifty-five patients who, in a twenty-eight-year period, had been managed with a biterminal open release because of congenital muscular torticollis, were re-examined at an average of fifteen years and a minimum of five years after the operation. Forty-eight patients reported no functional or cosmetic impairment. Palpable soft-tissue strands remained in twenty-nine patients, but bending toward the untreated side was limited more than 10 degrees in only one patient. The rate of recurrence was 2 per cent. Facial asymmetry improved or resolved in more than one-half of the patients. We recommend that biterminal release be performed at the age of three to five years in all patients who do not respond to non-operative treatment. Author-abstract.