青少年先天性肌性斜颈手术及术后处理

Treatment and rehabilitation of congenital muscular torticollis in youngsters

目的:大年龄先天性肌性斜颈往往由于继发畸形较重而治疗效果不佳,探讨青少年先天性肌性斜颈的手术治疗及术后康复措施,以提高患儿生活质量。方法:回顾性分析近9年来收治的获得随访的96例7～21岁的先天性肌性斜颈。采用胸锁乳突肌之胸骨头及锁骨头部分切除术91例、胸锁乳突肌延长术5例。术后行颈托牵引、手法矫正及颈托矫形支具综合治疗。结果:本组病例随访1～3年,96例中优51例,良35例,可10例,优良率89.6%。结论:大年龄先天性肌性斜颈经过综合治疗可以达到相当的矫形效果。胸锁乳突肌部分切除术该手术治疗严重先天性肌性斜颈,疗效确切,创伤小。胸锁乳突肌延长术受到限制,仅对部分病例有效。颈托牵引及颈托矫形支具综合治疗是一种简便而行之有效的术后处理方法。

AIM:To evaluate the methods of operation and postoperative rehabilitation in youngsters with congenital muscular torticollis(CMT).METHODS:96 children from 7 to 21 years old with CMT were retrospectively reviewed. 91 patients were operated by removing part of sternocleidomastiod muscle and 5 by lengthening of sternocleidomastiod muscle.All cases were given Glissin's traction,Maneuver correction and orthopaedic collar brace after operation.RESULTS:All were followed up for 1 to 3 years and average for 2.3 years. All of them, excellent result was got in 51 cases, good in 35 cases, fair in 10 cases.CONCLUSION:There would be good result for youngsters by operation and postoperative rehabilitation actively. The first style of operation on children for CMT is an appropriate method, Postoperative Glissin's traction and orthopaedic collar brace is a simple and effective treatment for older children.