Torticollis Contracture Release Surgery

Preparation

Before surgery, each patient requires an individual assessment and detailed evaluation of muscle function, head position, neck mobility, and range of motion.

Surgical treatment may be considered in cases of:

• persistent torticollis,
• significant restriction of head movement,
• asymmetry of the head and neck position,
• persistent shortening of the sternocleidomastoid muscle,
• progressive muscular contracture,
• head deformity persisting despite conservative treatment,
• chronic muscle tension causing discomfort,
• biomechanical disorders affecting the neck and shoulder girdle,
• lack of improvement despite rehabilitation and conservative therapy.

The treatment plan is always tailored to the patient’s age, severity of deformity, duration of the contracture, previous treatment history, and potential for functional improvement.

Conservative treatment remains the primary therapeutic approach in many cases and may include physiotherapy, stretching exercises, manual therapy, exercises improving movement patterns, and interventions supporting proper neck alignment.

Surgery is usually considered when the contracture becomes permanent, mobility restriction is significant, rehabilitation does not achieve satisfactory results, or the condition begins to interfere with daily activities.

Convalescence

Recovery after surgical release of contracture in torticollis requires active patient participation and a properly structured rehabilitation programme.

The treatment process typically includes:

• monitoring the healing process,
• exercises aimed at increasing neck mobility,
• therapy supporting proper head positioning,
• exercises improving the function of neck and shoulder girdle muscles,
• gradual restoration of normal movement patterns.

Rehabilitation is one of the most important elements of treatment and has a significant impact on maintaining long-term results.

Patients undergoing surgery may also benefit from a special 10% discount on rehabilitation at KCM Clinic, allowing treatment to continue in a comprehensive and coordinated manner.

The recovery plan is always tailored individually and depends on the severity of the contracture, surgical scope, healing progress, and the patient’s functional needs.

Precautions

Persistent torticollis may lead to long-term abnormal movement patterns and progressive changes in muscles and soft tissues.

If a long-standing contracture is not treated appropriately, it may result in:

• worsening asymmetry of head position,
• further restriction of neck mobility,
• increased muscle tension,
• overload of the neck and shoulder girdle muscles,
• development of postural abnormalities,
• reduced comfort in everyday life.

Torticollis is not only a problem of head positioning. A long-standing contracture may affect the function of the entire shoulder girdle, overall posture, and the way everyday activities are performed.

For this reason, selecting the appropriate timing for treatment plays an important role in achieving the best possible functional outcome.

Surgery is not always necessary, especially in children, where treatment usually begins with intensive rehabilitation. In adults, surgical treatment may be required more often when the contracture has been present for many years and has led to permanent movement restrictions.

Benefits

The main goal of surgical treatment is to improve head position, increase neck mobility, and reduce symptoms related to chronic muscle tension.

In appropriately selected cases, patients may experience:

• greater freedom of neck movement,
• improved symmetry of head positioning,
• reduced muscle tension,
• less discomfort during daily activities,
• improved alignment of the shoulders and neck,
• enhanced overall comfort and function,
• improved movement biomechanics,
• better quality of life.

Treatment aims not only to correct the contracture itself, but also to restore the most natural function possible throughout the musculoskeletal system.

The long-term outcome depends on the severity and duration of the contracture, surgical planning, and properly conducted postoperative rehabilitation.

What is surgical release of contracture in torticollis?

Surgical release of contracture in torticollis is a procedure performed to improve head alignment and increase neck mobility when contracted soft tissues cause persistent abnormal head positioning.

The goal is to reduce soft tissue tension, improve movement biomechanics, and restore more natural head and neck function.

What does the procedure involve?

The procedure involves releasing shortened and contracted structures responsible for limiting neck movement.

During surgery, the surgeon may divide or lengthen contracted muscle fibres, reduce excessive soft tissue tension, improve head and neck alignment, and increase the range of motion.

Which structures are most commonly released?

The procedure most commonly involves the sternocleidomastoid muscle.

Shortening of this muscle is often responsible for the characteristic head position seen in patients with torticollis.

Depending on the individual case, other contracted soft tissues affecting neck mobility may also be released.

When is surgery considered?

Surgery may be considered when torticollis persists despite rehabilitation and conservative treatment.

It may also be considered in cases of significant restriction of head movement, persistent muscle shortening, progressive contracture, chronic muscle tension, head and neck asymmetry, or biomechanical disorders affecting the neck and shoulder girdle.

What results can be expected after surgery?

In appropriately selected cases, patients may experience improved head position, greater neck mobility, reduced muscle tension, less discomfort during daily activities, improved shoulder and neck alignment, and better overall function.

Treatment outcomes depend on the severity and duration of the contracture and the quality of postoperative rehabilitation.

Why does a long-standing contracture require attention?

Persistent torticollis may lead to abnormal movement patterns and progressive changes in muscles and soft tissues.

Over time, it may cause worsening head asymmetry, further restriction of neck mobility, increased muscle tension, overload of the neck and shoulder girdle, postural abnormalities, and reduced daily comfort.

What does recovery involve?

Recovery requires a structured rehabilitation programme and active patient participation.

Rehabilitation usually includes exercises to increase neck mobility, therapy supporting proper head positioning, exercises for the neck and shoulder girdle muscles, and gradual restoration of normal movement patterns.

Is rehabilitation important after surgery?

Yes. Rehabilitation is one of the most important elements of treatment.

It has a significant impact on maintaining long-term results, improving mobility, restoring proper movement patterns, and supporting functional recovery.

Is surgery always necessary?

No. Conservative treatment remains the primary treatment approach in many cases.

It may include physiotherapy, stretching exercises, manual therapy, exercises aimed at improving movement patterns, and interventions supporting proper neck alignment.

Surgery is usually considered when the contracture becomes permanent, mobility restriction is significant, rehabilitation does not provide satisfactory results, or the condition interferes with daily activities.

Is treatment the same for children and adults?

Not always.

In children, treatment usually begins with intensive rehabilitation, and surgery is considered only when the contracture persists despite properly conducted therapy.

In adults, surgery may be required more often, especially when the contracture has been present for many years and has caused permanent movement restrictions.

What is the main goal of treatment?

The primary goal is not only to increase neck mobility, but also to restore the most natural head position possible, improve movement biomechanics, reduce discomfort, and enhance overall quality of life.

Why is individual assessment important?

Each case of torticollis may differ in severity, duration, underlying cause, muscle involvement, and potential for functional improvement.

Individual assessment allows the treatment plan to be adapted to the patient’s condition, needs, and expected outcome.