Dynamic Torticollis Orthosis – A new design concept of Cervical Orthosis for children with Torticollis

Abstract

Background:Torticollis or Wry neck is a rare condition in which neck muscles contract, causing the head to tilt to one side. This causes painfully twisted and tilted neck. The top of the head generally tilts to one side while the chin to the other side. Torticollis is a 3 dimensional deformity where cervical flexion occurs in the sagittal plane, lateral flexion in the frontal plane and rotation of head in the transverse plane. Although there are cervical orthosis available, studies on a Dynamic Cervical Orthosis that can correct the above mentioned deformities of torticollis is less. Materials and Methods: The Dynamic Torticollis Orthosisis fabricated mainly using low temperature thermoplastic (LTTP). After heating the LTTP in a hot water bath, it can be directly molded onto the patient’s neck. Another method is by taking a cast of the patient’s neck. Using the cast, a POP mold is made and on that the required modifications are done. After modification, draping can be done on the mold. Results: The Dynamic Torticollis Orthosis applies two corrective forces; one below the chin and the other on the lateral side of head, above and slightly posterior to the ear. These corrective forces helps to bring the head back to its neutral position. The magnitude of force being applied can be altered by adjusting the turnbuckles. Conclusion: Since the corrective forces applied can be increased and decreased manually, slow and gradual correction can be done in case of children with stiff torticollis, as the corrective forces can be gradually increased on a weekly basis.