Fifty-seven patients with congenital muscular torticollis who were
treated between 1941 and 1977 were evaluated after an average follow-up of
18.9 years. We found that if congenital muscular torticollis persisted
beyond the age of one year, it did not resolve spontaneously. Children with
torticollis who were treated during the first year of life had better
results than those treated later, and an exercise program was more likely
to be successful when the restriction of motion was less than 30 degrees
and there was no facial asymmetry or the facial asymmetry was noted only by
the examiner. Non-operative therapy after the age of one year was rarely
successful. Regardless of the type of treatment, established facial
asymmetry and limitation of motion of more than 30 degrees at the beginning
of treatment usually precluded a good result. While these fifty-seven
patients had little functional abnormality at follow-up (some of those with
a persistent head tilt had mild, asymptomatic compensatory scoliosis),
noticeable cosmetic deformity was present in approximately 31 per cent of
the patients.