scholarly journals TORTIKOLIS MUSKULAR KONGENITAL

2014 ◽  
Vol 5 (3) ◽  
Author(s):  
Imelda E. Kawatu ◽  
Engeline Angliadi

Abstract: Torticollis, or wryneck, is a group of symptoms based on many causes that clinically manifests itself as a crooked or rotated neck. Congenital muscular torticollis is the most common type of congenital torticolllis which occurs in four per 1000 births and one per 300 live births with 75% of these cases on the right side. It was found that 90.1% of plagiocephalic cases incured this torticollis. In this condition, due to contractions of the neck muscles, the head turns and tilts to one side, meanwhile the chin points to the opposite side. Congenital muscular torticollis is caused by a shortening of the sternocleidomastoid muscle due to trauma during labour or abnormal fetal position in utero. Signs and symtoms of congenital muscular torticollis are recognized as early as two months after birth in which the head turns to one side associated with neck muscle hypertrophy, muscle spasm, and a limited range of motion (ROM). The management of congenital muscular torticollis consists of pharmacological, non-pharmacological, and surgical treatments. The prognosis is stated as good if there is a good improvement after 6 months of rehabilitation, but it is stated bad if there is no improvement after 6 months of treatment with a continuation of the asymetrical face. Keywords: congenital muscular torticollis, management   Abstrak: Tortikolis adalah kekakuan leher yang menimbulkan spasme otot yang secara klinis bermanifestasi sebagai leher yang bengkok atau terputar. Tortikolis bukan merupakan suatu diagnosis melainkan kumpulan gejala dengan berbagai gangguan yang mendasarinya. Tortikolis muskular kongenital ialah bentuk yang paling umum dari tortikolis kongenital dengan insiden sekitar 4 per 1000 kelahiran, dan 1 dari setiap 300 kelahiran hidup. Pada tortikolis muskular kongenital terjadi kontraksi otot-otot leher (75% terbanyak pada sisi kanan) yang menyebabkan posisi kepala turn dan tilt ke satu sisi dan dagu mengarah ke sisi yang berlawanan. Penyebab terjadinya tortikolis muskular kongenital ialah pemendekan otot sternokleidomastoid akibat trauma selama proses persalinan, atau posisi bayi dalam kandungan. Umumnya, gejala dan tanda klinis diketahui pada 2 bulan pertama dimana kepala mengarah ke arah sisi sakit, pembesaran otot-otot leher, spasme otot, dan keterbatasan lingkup gerak sendi leher. Penanganan tortikolis muskular kongenital terdiri dari farmakologis, non-farmakologis, dan pembedahan. Prognosis disebut baik bila tercapai hasil yang baik setelah 6 bulan terapi dengan penanganan rehabilitasi, dan memburuk bila tidak terdapat perubahan dalam 6 bulan terapi ditandai oleh wajah yang asimetris. Kata kunci: tortikolis muskular kongenital, penanganan

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 735
Author(s):  
Jun-il Park ◽  
Joo-Hyun Kee ◽  
Ja Young Choi ◽  
Shin-seung Yang

It has been reported that congenital muscular torticollis (CMT) may result in secondary scoliosis over long-term follow-ups. However, there are few reports on whether CMT causes pelvic malalignment syndrome (PMS). This study aimed to investigate the relationship between CMT and PMS and to determine the factors associated with the development of PMS in children with longstanding CMT. Medical records of 130 children with CMT who had long-term follow-up were reviewed retrospectively. The chi-squared test and logistic regression analysis were used to determine which initial clinical parameters contributed to the development of PMS. Among 130 children with CMT, 51 (39.2%) developed PMS with or without compensatory scoliosis during long-term follow-up, indicating a high prevalence of PMS in children with a CMT history. Initial clinical symptoms such as a limited range of motion of the neck or the presence of a neck mass could not predict the development of PMS. Even if the clinical symptoms are mild, long-term follow-up of children with CMT is essential to screen for PMS.


2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Koichi Yano ◽  
Yasunori Kaneshiro ◽  
Hideki Sakanaka

A 24-year-old right-handed man suffered right olecranon and lateral epicondylar fracture from high energy trauma. Fixation of olecranon was performed by a previous doctor. Three months after operation, he presented with limited range of motion (ROM) of the right elbow caused by malunion of the lateral epicondylar fracture and subluxation of the radiohumeral joint. Preoperative ROM of the right elbow was flexion 110° and extension −75°. Forearm rotation was pronation 85° and supination 65°. Fragment excision of the lateral epicondyle, which was 27 mm in length, and lateral collateral ligament repair using anchors were performed. Fourteen months postoperatively, contracture release of the elbow was performed. Twenty-four months postoperatively, radiograph of the elbow showed normal congruence without osteoarthritic changes and the ROM of the right elbow was flexion 120° and extension −35°. Forearm rotation was pronation 90° and supination 70°. In the surgical setting, in case of the size of the lateral epicondylar fragment is relatively large, the fragment should be fixed or lateral collateral ligament should be repaired when the instability of the elbow is found.


2016 ◽  
Vol 31 (8) ◽  
pp. 1098-1106 ◽  
Author(s):  
Esra Giray ◽  
Evrim Karadag-Saygi ◽  
Basak Mansiz-Kaplan ◽  
Duygu Tokgoz ◽  
Ozun Bayindir ◽  
...  

Objective: To investigate the effects of kinesiology taping and different types of application techniques of kinesiology taping in addition to therapeutic exercises in the treatment of congenital muscular torticollis. Design: Prospective, single blind, randomized controlled trial. Setting: An outpatient rehabilitation clinic in a tertiary university hospital. Subjects: Infants with congenital muscular torticollis aged 3-12 months. Interventions: Group 1 included 11 infants who only received exercises, Group 2 included 12 infants who received kinesiology taping applied on the affected side by using inhibition technique in addition to exercises. Group 3 included 10 infants who additionally received kinesiology taping applied on the unaffected side by using facilitation technique and on the affected side by using inhibition technique. Main measures: Range of motion in lateral flexion and rotation of the neck, muscle function and degree of craniofacial changes were assessed at pretreatment, post treatment and, 1 month and 3 months’ post treatment. Results: Friedman analysis of within-group changes over time revealed significant differences for all of the outcome variables in all groups except cervical rotation in Group 3 ( P<0.05). No significant differences were found between groups at any of the follow-up time points for any of the outcome variables ( P>0.05). Conclusions: There is no any additive effect of kinesiology taping to exercises for the treatment of congenital muscular torticollis. Also different techniques of applying kinesiology taping resulted in similar clinical outcomes.


2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110098
Author(s):  
Yi Zhao ◽  
Qianqian Zhang ◽  
Helin Feng ◽  
Xiyan Zhu

The incidence of tumours found in the patella, including primary and metastatic tumours, is low. Solitary metastasis of oesophageal carcinoma (OC) in the patella is even rarer. A 50-year-old man presented to our clinic because of pain and limited range of motion in the right knee for 4 hours and after a fall. On the basis of the patient’s medical history, he was diagnosed with OC 2 months previously and underwent two cycles of paclitaxel liposome combined with tiggio chemotherapy (oral tiggio, 40 mg, two times/day, with a treatment cycle of 3 weeks). A 99mTc-methylene diphosphonate bone scintigraphy scan showed increased radioactivity in the right patella. A right knee biopsy showed the presence of patellar metastasis from OC. Unfortunately, the patient denied additional treatment and was discharged for personal reasons. At the 1-month follow-up, which was conducted by a telephone survey, we learned that the patient had died of acute pulmonary embolism. X-rays and computed tomography are useful for diagnosing patellar metastases, but 99mTc-methylene diphosphonate bone scintigraphy can help physicians diagnose patellar metastasis of OC more rapidly. Biopsy with pathology is the gold standard for diagnosing patellar metastases. Additionally, timely surgical treatment prolongs the survival time of these patients.


2017 ◽  
Vol 6 (3) ◽  
pp. 69-71
Author(s):  
B D Sharma ◽  
J Sitaula ◽  
A Prajapati ◽  
A P Regmi

Osteochondromas are the most common benign tumours of bone. They are most commonly seen in the metaphyseal regions of long bones (femur, tibia, humerus). The scapula is rarely involved, and very few cases of solitary osteochondroma of scapula have been reported in literature. We present the case of a 17 year old male who presented with pain and limited range of motion of his right shoulder. CT scan revealed an osteochondroma on the dorsomedial surface of the right scapula extending into the ventral surface. Surgical excision was done and histopathological study showed osteochondroma of the scapula.


Author(s):  
Nabeela Fatema ◽  
Bodhisattva Dass ◽  
Rinkle Hotwani

Background: Tennis elbow can be caused by repetitive wrist and arm motions. Pain is the primary symptom. It usually occurs on the outside of the elbow and sometimes in the forearm and wrist. Treatment includes rest, pain relievers and physiotherapy. Case Presentation: A 28years old male patient presented with a complaint of pain in outer side of the right side elbow. In subjective examination, He gave history of pain while playing tennis mainly in smashing the ball or passing shot, riding bike for more than 2kilometers, difficulty in holding objects sometimes as well. When this pain was unbearable to him he came to Physiotherapy department. Treatment: A Treatment session initially started with Cryotherapy (Ice Pack) application for 5min. On lateral epicondyle of right elbow. Then Ultrasound 0.8 watt/Cm² for 7minutes given, these helped in pain reduction. After 2days patient is asked to follow the commands to perform Triceps strengthening along with wrist strengthening with the help of Half Kg Dumb bell.  There was an effect on the reduction of the symptoms of the patient which were pain, reduce strength and limited range of motion of wrist in right hand. After 1week of treatment, we added Mobilization with movement (Mulligan) technique at elbow joint. The same procedure was continued for 2weeks after which patient's symptoms were minimized as to the day of assessment. Outcome measures used for the evaluation of the symptoms were NPRS Scale for Pain, Manual Muscle Testing (MMT) for Strength. Conclusion: Triceps strengthening along with Mulligan technique for elbow joint was found to be effective in patients with severe pain and reduced strength.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hiva Mohamadian ◽  
Mansour Bahardoust ◽  
Borzouyeh Molazem Sanandaji ◽  
Saba Saberi

Abstract Background Dysplasia epiphysealis hemimelica (DEH) is a rare benign overgrowth generally affecting the epiphyses and short bones of the lower limbs. DEH in the elbow joint is extremely rare, and to date, only three cases of DEH have been reported in the radial head. Case presentation In this study, we report a case of DEH located in the radial head of the right elbow of a 10-year-old boy, which was presented with elbow pain and limited range of motion. In clinical examination, an asymmetrical enlargement was observed over the elbow. The lesion was resected surgically, and the patient’s symptoms resolved afterward. The histologic analysis of the lesion confirmed the diagnosis of DEH. Conclusion This report highlights the role of DEH in the differential diagnosis of elbow pathologies, particularly its differentiation from osteochondroma.


Author(s):  
Kenji Ohira ◽  
Yoshitaka Hamada ◽  
Takeyasu Toyama ◽  
Yoshitaka Minamikawa

Abstract The surgical soft tissue release of extension contracture at metacarpophalangeal (MP) joint is technically easy; however, the preventive hand therapy after surgery is really difficult in clinical practice. Congenital MP joint contracture, especially little finger, is also difficult to spread its limited range of motion (ROM). Here, we present a patient with a congenital MP joint contracture of the little finger managed with dynamic external fixator (DEF). A 21-year-old male irritated from limited ROM associated with pain of the right little finger of more than 1 year. The symptom started after trauma on his hand while playing lacrosse. Further examination revealed that his MP joint was congenitally contracted. To address this pathology, DEF followed by orthotic therapy was done. Two years after the procedure and therapy, the MP joint ROM of the finger surpassed that of the contralateral unaffected digit without pain and recurrence. The patient was able to return to his sports of lacrosse.


2021 ◽  
pp. 1-9
Author(s):  
Saverio Comitini ◽  
Saverio Comitini ◽  
Giuseppe Mobilia ◽  
Matteo Berti ◽  
Luca Amendola ◽  
...  

Background: The trapeziometacarpal joint is the second joint affected by osteoarthritis in the hand. The symptoms and clinical presentation are characterized by pain, limited range of motion, muscle weakness with loss of strength, bone deformities and disability. The symptomatology often is not related to the radiographic grade of osteoarthrosis. Therefore, in addition to the radiographic stage of the disease, the treatment is influenced by multiple variables such as age, functional requirement, symptoms and stability of the joint. Objective: There are several options of surgical treatments. Although trapeziectomy and its technical variation is the gold standard for treatment, prosthesis replacement can be used with good results. This case report discusses the case of a 70-year-old male who presents bilateral trapeziometacarpal osteoarthrosis treated with two different techniques with different timelines. Methods: The patient underwent a trapeziectomy on the right hand and arthroplasty with implant on the left. In both TMC the stage of the disease was grade III according to the Eaton Litter classification and the results were evaluated according to clinical and radiographic criteria. The NPRS pain scale and the Quick Dash functional scale were used in subsequent checks. The mean follow-up was 12 months. Conclusion: There were no significantly different results with respect to pain, activities of daily living, mobility or strength. No complications were observed. The patient is satisfied with the treatment having found a better and earlier resumption of daily activity of the left hand treated with prosthesis replacement.


Author(s):  
Sotetsu Sakamoto ◽  
Kazuteru Doi ◽  
Yasunori Hattori ◽  
Sam Supreeth ◽  
Shichoh Sonezaki ◽  
...  

AbstractWe report a case of a missed wooden foreign body in the metacarpophalangeal (MP) joint of the right little finger following a workplace injury. The patient presented to our institution with a persisted pain and limited range of motion of the MP joint 1 week following the injury. Plain radiographs detected no foreign body or fractures. However, detailed examination as ultrasonography (USG) and computed tomography revealed the presence of a foreign body of 10 × 1.5 mm size in the MP joint capsule. The excision of the radiolucent foreign body was performed arthroscopically and was confirmed successful removal using intraoperative USG. The foreign body was recognized as a wooden piece. The patient was immediately pain free postoperatively and regained full range of motion. Arthroscopy can be a practical, reliable method to remove a radiolucent foreign body located in a small joint in a minimally invasive manner, and USG can help surgeons confirm no remnants left.


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