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Torticollis M43.6 723.5

  Torticollis ICD-10

Torticollis ICD-9

  • 723.5 Torticollis, unspecified

Torticollis Natural History / Etiology

  • any deformity in which the head is tilted and abnormally rotated
  • Congenital Muscular Torticollis=most common cause in infancy. Caused by contracture of the sternocleidomastoid muscle.  Associated with metatarsus adductus, DDH, clubfoot. 
  • Childhood torticollis is commonly cause by Atlantoaxial rotatory displacement. (JBJS 1989; 71A)
  • Persistent torticollis may lead to skull and facial deformities

Torticollis Differential Diagnosis

  • congenital muscular torticollis
  • osseous malformation
  • Klippel-Feil syndrome
  • posterior fossa tumor
  • syringomyelia
  • Arnold-Chiari
  • ocular dysfunction
  • Grisel’s Syndrome, etc

Torticollis Xray

  • c-spine films to r/o bony abnormality
  • consider CT if occurs ofter trauma and pt has normal xrays

Torticollis Treatment

  • <1y/o=sternocleidomastoid muscle stretching.  Stretch contralateral ear to the shoulder and gently push the chin to touch the shoulder on the same side as the contracture.  90% resolve with stretching. 
  • >2y/o=unipolar or bipolar sternocleidomastoid release.

Torticollis References

  • Lincoln, JAAOS 2003;11:312-320

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