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Torticollis

Pediatric PT

QuestionAnswer
WHAT IS TORTICOLLIS? Derived from Latin: Torta = twisted Collum = neck Also known as: Wry Neck Turtle Neck Twisted Neck
SIGNS and SYMPTOMS and DX Head tilt with rotation ___-not always Elevated shoulder girdle ___ in the belly of the muscle Limited ROM Difficulty visual ___ ___ of the face and/or skull Difficulty breast feeding opposite Lump/mass in the belly of the muscle Difficulty visual tracking Asymmetry of the face and/or skull
OCCURRENCE One in ___ live births ___ as a coexisting impairment -80-90% Hip ___ -20% Scoliosis Club foot Metatarsus Adductus 300 Plagiocephaly as a coexisting impairment Hip Dysplasia
TYPES Congenital Muscular Torticollis 1. Present at birth Acquired Torticollis 1. Traumatic 2. Spas___ 2. Spasmodic
CONGENTIAL TORTICOLLIS ___ common form SCM-___ syndrome -Palpable mass -Trauma during birth -___ injury -Intrauterine ___ Most common form SCM-compartment syndrome -Ischemic injury -Intrauterine positioning
CAUSES of CMT (Congenital Muscular Torticollis) ___ birth Large BW Sustained head ___ position Decreased ___ to SCM Cervical spine anomaly/malformation Forceps delivery Breech birth Sustained head down position Decreased circulation to SCM Forceps delivery
PHYSICAL FEATURES ___cephaly ___ of ears ___ of the side of the neck under the ear Flattening of the mandible ___ tilting of the lower jaw and gum line Elevation of the TMJ Limited movement of the neck Asymmetries of the back, chest, hips and feet Plagiocephaly Asymmetry of ears Depression of the side of the neck under the ear Upward tilting of the lower jaw and gum line
ACQUIRED TORTICOLLIS Acute trauma -Fracture, clavicle, scapula Non-traumatic(3): 1. Boney deformities- C1, C2 ___ -Inflammatory processes 2. Without boney deformities -___ lesion, neurological syndromes -Inflammation/infection 3. Painful Torticollis -Oste 1. C1, C2 subluxation 2. -Ocular lesion, neurological syndromes 3. -Osteoid osteoma, osteoblastoma
ASSESSEMENT ROM -NECK, UE’s, LE’s, Trunk VISION SKIN DEVELOPMENTAL SKILLS RIGHTING AND EQUILIBRIUM ASYMMETRIES -___cephaly Plagiocephaly
TREATMENT Regain passive and active ROM Skin integrity Facilitate WB, WS Righting and equilibrium reactions Visual tracking ___ degrees, up/down Visual tracking 180 degrees, up/down
PERSISTENT TORTICOLLIS Rule out the following: 1. Retro-___ abscess 2. ___ tumors 3. Soft tissue mass with ___ tissue 4. Fracture 5. Cervical abnormality 6. Visual abnormality 1. Retro-pharyngeal abscess 2. Orbital tumors 3. Soft tissue mass with fibrotic tissue
Created by: John L