Fifty-five patients who, in a twenty-eight-year period, had been managed
with a biterminal open release because of congenital muscular torticollis,
were re-examined at an average of fifteen years and a minimum of five years
after the operation. Forty-eight patients reported no functional or
cosmetic impairment. Palpable soft-tissue strands remained in twenty-nine
patients, but bending toward the untreated side was limited more than 10
degrees in only one patient. The rate of recurrence was 2 per cent. Facial
asymmetry improved or resolved in more than one-half of the patients. We
recommend that biterminal release be performed at the age of three to five
years in all patients who do not respond to non-operative treatment.