{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:52:05Z","timestamp":1792633925716,"version":"4.5.0"},"reference-count":22,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Congenital muscular torticollis (CMT) is a common musculoskeletal anomaly that can be excellently managed at birth with conservative physiotherapy; as a result, literature on neglected cases of CMT in older patients is sparse, and there is controversy regarding the ideal surgical approach. This report aims to provide the outcome of 28 adolescent patients with neglected CMT who underwent unipolar release at the distal sternocleidomastoid muscle (SCM).<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Twenty-eight adolescent patients with untreated CMT presented to our department between 2016 and 2019 and underwent unipolar release at the distal end of their SCM. All patients had no other anomaly based on clinical examination and radiological investigations. At the time of surgery, the mean age of patients was 15.8 years (range 13\u201318 years). There were 10 male and 18 female patients with the right side affected in 20 cases. All patients were followed up for 2 years. Patients were evaluated using an adapted version of the modified Lee\u2019s scoring system to assess cosmesis and the cervical-mandibular angle (CMA) to assess radiological change.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The adapted modified Lee\u2019s scoring system indicated 17 patients (60.7%) had an excellent outcome, 6 patients (21.4%) had a good outcome, and 5 patients (17.9%) had a fair outcome. In particular, scarring was fine in 23 patients (82.1%) and only slight in the remaining. Independent to the categorical outcome, all patients subjectively reported high satisfaction with their cosmesis. The preoperative mean CMA was 19.6\u00b0 (range, 8.5\u201331.5\u00b0), which was reduced to a mean of CMA of 14.0\u00b0 (range, 3\u201328\u00b0) after surgery (\n P<\/jats:italic>\n < 0.05). No patient developed any permanent complication or required surgery for recurrence. No serious postoperative complications such as infection or hematoma were observed.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n In uncomplicated cases of neglected CMT in adolescent patients, unipolar tenotomy of the distal SCM is a safe and reliable technique with good clinical outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_314_2022","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T03:38:26Z","timestamp":1657251506000},"page":"292","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Outcome of surgical treatment for neglected congenital muscular torticollis: A series of 28 adolescent patients"],"prefix":"10.25259","volume":"13","author":[{"given":"Usman Ahmad","family":"Kamboh","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan,"},{"name":"Wolfson School of Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shah Gul","family":"Zahra","sequence":"additional","affiliation":[{"name":"School of Medicine, King Edward Medical University, Lahore, Punjab, Pakistan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Asif","family":"Raza","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehwish","family":"Manzoor","sequence":"additional","affiliation":[{"name":"Administration, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehreen","family":"Mehboob","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minaam","family":"Farooq","sequence":"additional","affiliation":[{"name":"School of Medicine, King Edward Medical University, Lahore, Punjab, Pakistan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manzoor","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Shahzad","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveed","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2022,7,8]]},"reference":[{"key":"10.25259\/SNI_314_2022\/ref-1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/BF00451875","article-title":"Congenital muscular torticollis: Long-term follow-up of thirty-eight partial resections of the sternocleidomastoid muscle","volume":"112","author":"Akazawa","year":"1993","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.25259\/SNI_314_2022\/ref-2","doi-asserted-by":"crossref","first-page":"810","DOI":"10.2106\/00004623-198264060-00002","article-title":"Congenital muscular torticollis. 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