a modified bipolar release and post operative approach for the management of congenital torticollis

in an evaluation of nine cases (5 females, 4 males, 2.5 to 22 years old) with congenital torticollis who had been treated by bipolar release of sterno-cleido-mastoid muscle at emam khomeini hospital, department of orthopedic surgery between 1981-1994, all of the patients were satisfied with cosmetic and functional results. in spite of palpable soft tissue remaining in some patients, limitation of bending to the opposite side was below ten degrees. facial asymertery improved in older and resolved in younger children with no recurrence and occurrence of diplopia. recommendations: 1) operative treatment of congenital torticollis should be considered beyond the age of 12 months and even over 19 years old. 2) bipolar tenatomy, cephalad and caudal release of the sterno-cleido-mastoid has better results than limited procedures in older children, especially beyond 3 years old. 3) postoperatively, early range of motion exercises in extension, and not in flexion is highly recommended.