A treatise on orthopedic surgery . hildhood, for inmany instances the shortened muscle ceases to grow; thus, anoriginal shortening of half an inch, as compared to its fellow,may be increased to two or more inches in later years. Thisfact emphasizes the importance of treatment as soon as may bepossible after distortion is discovered. As has been stated, the important contraction is usually of thesternomastoid muscle, but if the deformity is uncorrected all thelateral tissues become shortened. Typical wryneck caused by shortening of the sternomastoid43 674 OBTEOFEDIC SUBGERY. muscles is by far t
A treatise on orthopedic surgery . hildhood, for inmany instances the shortened muscle ceases to grow; thus, anoriginal shortening of half an inch, as compared to its fellow,may be increased to two or more inches in later years. Thisfact emphasizes the importance of treatment as soon as may bepossible after distortion is discovered. As has been stated, the important contraction is usually of thesternomastoid muscle, but if the deformity is uncorrected all thelateral tissues become shortened. Typical wryneck caused by shortening of the sternomastoid43 674 OBTEOFEDIC SUBGERY. muscles is by far tlie most common form of congenital torticollis,but occasionally cases are seen in which the head is but slightlyinclined to one side and in which the shortening appears to in-volve the lateral tissues in general rather than a particularmuscle. In rare instances, although the deformity resemblesthat of typical torticollis, the gTeatest shortening will be foundto be of the posterior muscles on one side, particularly of the Fig. Right torticollis, showing the displacement of the head toward the opposite side. trapezius and the levator angidi scapulEe. Thus the scapularmay be elevated and tilted forward. This form of torticollisappears to be one variety of congenital elevation of the scapula.(See page 230.) Torticollis due to defective development of theupper extremity of the spine is a rare deformity that does notrequire special description. —It may be assumed, disregarding the possible influ-ence of hereditary predisposition, that congenital torticollis is, inmost instances, caused by a constrained or fixed position in theuterus for a longer or shorter time l^efore birth. It is, in fact,a simple distortion, and that it has, in the majority of cases, nodeeper significance is proved by the fact that it may be easily CONGENITAL AND ACQUIEED TOETICOLLIS. 675 and completely cured by simj)le division or elongation of thecontracted tissues. Haematoma of the Stemomastoi
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