Objective To determine the response of torticollis including sternocleidomastoid tumor to physiotherapy and positioning. Study design Descriptive case series. Place & Duration of study Department of Paediatric Medicine at Chandka Medical College (CMC), Shaheed Muhatarma Benazir Bhutto University, Larkana, from January 2007 to June 2008. Methodology All children with swelling at the side of neck, difficulty in head movement, not feeding on one side of breast and with the history of prolonged or difficult labor, were included. Diagnosis of torticollis and /or sternocleidomastoid tumor was based on history and physical examination of the swelling in the neck. They were advised physiotherapy and proper position as per protocol for 4 weeks to 24 weeks. Patients were reviewed at 4 weeks interval for response to physiotherapy. The data were analyzed by SPSS version 10.0. Results A total of 170 patients of torticollis were enrolled during the study period. Most of the cases were below four weeks of age (n 61- 35.9%) with overall male to female ratio of 1.4:1. The common presentation of torticollis were excessive cry with neck movement (n105, 61.7%), followed by sternocleidomastiod tumor or swelling on side of neck (n 95, 55.09%), history of prolonged/difficult labor (n 84, 49.04%) and not feeding from one side of breast (n 75, 44.11%). Major physical signs were head tilt on one side in all cases and swelling in right side of neck in 95(55.09%) cases. 154 (90.60%) patients improved completely within 4 weeks to 4 month of physiotherapy while 15 (8.80%) cases showed partial improvement. Conclusion Majority of cases completely improved on physiotherapy and rest showed considerable improvement.
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