Li Haichong,Li Hao,Guo Dong,et al.Arthroscopically assisted radiofrequency tenotomy for congenital muscular torticollis in children[J].Journal of Clinical Pediatric Surgery,,():648-652.[doi:10.3760/cma.j.cn101785-202212036-008]
Arthroscopically assisted radiofrequency tenotomy for congenital muscular torticollis in children
- Keywords:
- Congenital Muscular Torticollis; Arthroscopy; Radiofrequency; Surgical Procedures; Operative; Child
- Abstract:
- Objective To discuss the advantage of arthroscopically assisted radiofrequency tenotomy of sternocleidomastoid muscle for congenital muscular torticollis (CMT) in children.Methods From June 2019 to June 2022,the relevant clinical data were retrospectively reviewed for 83 CMT children.According to the 2018 American Physical Therapy Association’s clinical practice guidelines of children with muscular torticollis,disease severity was graded pre-operation.Based upon specific operations,they were assigned into two groups of arthroscopiclly assisted radiofrequency tenotomy (n=46) and open operation (n=37).Outpatient re-examinations were performed at Week 1 and Month 1/3 post-operation.Postoperative follow-ups were conducted with Cheng’s scoring system.Results Clinical grades were Ⅷ (n=82) and Ⅶ (n=1).No significant inter-group differences existed in gender ratio,operative age,medical history or preoperative severity.Operative duration of radiofrequency tenotomy group was longer than that of open operation group .Incision length and postoperative hospitalization stay were significantly shorter in radiofrequency tenotomy group than those in open operation group and (3.3±1.1) vs.(3.6±1.6) day,P<0.001].During an average follow-up period of (1.8±1.0) years,Cheng’s score was excellent (n=80) and decent (n=3).Two cases of subcutaneous effusion occurred in each group.No inter-group difference existed in complication rate or Cheng’s score.Conclusions Operative duration of radiofrequency tenotomy of CMT is longer than that of open operation.Arthroscopically assisted radiofrequency therapy for CMT offers the advantages of safety,mini-invasiveness and satisfactory efficacy.
References:
[1] 邱鑫,熊竹,曾帅丹,等.腔镜治疗儿童先天性肌性斜颈的系统评价和Meta分析[J].中华小儿外科杂志,2021,42(5):392-402.DOI:10.3760/cma.j.cn421158-20200215-00071. Qiu X,Xiong Z,Zeng SD,et al.Endoscopy for congenital muscular torticollis in children:a systematic review and Meta-analysis[J].Chin J Pediatr Surg,2021,42(5):392-402.DOI:10.3760/cma.j.cn421158-20200215-00071.
[2] Jeong KY,Min KJ,Woo J,et al.Craniofacial asymmetry in adults with neglected congenital muscular torticollis[J].Ann Rehabil Med,2015,39(3):440-450.DOI:10.5535/arm.2015.39.3.440.
[3] Min KJ,Ahn AR,Park EJ,et al.Effectiveness of surgical release in patients with neglected congenital muscular torticollis according to age at the time of surgery[J].Ann Rehabil Med,2016,40(1):34-42.DOI:10.5535/arm.2016.40.1.34.
[4] Sytsma TT,Terman RW,Brandenburg JE.Custom neck orthosis in combination with onabotulinumtoxinA for the treatment of refractory congenital muscular torticollis:a case report[J].J Pediatr Rehabil Med,2016,9(2):155-158.DOI:10.3233/PRM-160369.
[5] Kim SH,Ahn AR,Yim SY.Congenital muscular torticollis concurrent with sagittal synostosis:a case report[J].Ann Rehabil Med,2014,38(5):712-716.DOI:10.5535/arm.2014.38.5.712.
[6] 赵章帅,唐盛平,熊竹.婴儿先天性肌性斜颈保守综合治疗1142例[J].临床小儿外科杂志,2016,15(6):551-557.DOI:10.3969/j.issn.1671-6353.2016.06.009. Zhao ZS,Tang SP,Xiong Z.Comprehensive treatments of infants with congenital muscular torticollis:a report of 1142 cases[J].DOI:10.3969/j.issn.1671-6353.2016.06.009.
[7] Kim JH,Yum TH,Shim JS.Secondary cervicothoracic scoliosis in congenital muscular torticollis[J].Clin Orthop Surg,2019,11(3):344-351.DOI:10.4055/cios.2019.11.3.344.
[8] Wang JL,Qi W,Liu YJ.Endoscopic release of congenital muscular torticollis with radiofrequency in teenagers[J].J Orthop Surg Res,2018,13(1):100.DOI:10.1186/s13018-018-0801-6.
[9] Kaplan SL,Coulter C,Sargent B.Physical therapy management of congenital muscular torticollis:a 2018 evidence-based clinical practice guideline from the APTA Academy of Pediatric Physical Therapy[J].Pediatr Phys Ther,2018,30(4):240-290.DOI:10.1097/PEP.0000000000000544.
[10] 孔萌,武玉睿,张士松,等.腔镜下胸锁乳突肌切断松解术治疗先天性肌性斜颈的临床分析[J].中国医学创新,2016,13(4):115-118.DOI:10.3969/j.issn.1674-4985.2016.04.033. Kong M,Wu YR,Zhang SS,et al.Clinical analysis of sternocleidomastoid cut loosening for congenital muscular torticollis under laparoscopy[J].Med Innov China,2016,13(4):115-118.DOI:10.3969/j.issn.1674-4985.2016.04.033.
[11] Limpaphayom N,Kohan E,Huser A,et al.Use of combined botulinum toxin and physical therapy for treatment resistant congenital muscular torticollis[J].J Pediatr Orthop,2019,39(5):e343-e348.DOI:10.1097/BPO.0000000000001302.
[12] Sargent B,Kaplan SL,Coulter C,et al.Congenital muscular torticollis:bridging the gap between research and clinical practice[J].Pediatrics,2019,144(2):e20190582.DOI:10.1542/peds.2019-0582.
[13] Kamboh UA,Ashraf M,Zahra SG,et al.Outcome of surgical treatment for neglected congenital muscular torticollis:a series of 28 adolescent patients[J].Surg Neurol Int,2022,13:292.DOI:10.25259/SNI_314_2022.
[14] Pan P.The transaxillary subcutaneous endoscopic sternocleidomastoid muscle division as an approach for the surgical treatment of congenital muscular torticollis in children[J].Indian J Otolaryngol Head Neck Surg,2020,72(1):123-127.DOI:10.1007/s12070-019-01770-3.
[15] Shan JL,Jiang H,Zhang Y,et al.The effectiveness of a novel surgical approach for the treatment of congenital muscular torticollis[J].Medicine (Baltimore),2020,99(14):e19572.DOI:10.1097/MD.0000000000019572.
Memo
收稿日期:2022-12-16。
基金项目:北京市自然科学基金(L222095)
通讯作者:张学军,Email:zhang-x-j04@163.com