Wryneck (Torticollis), a surgical disease, dependent generally on contraction of the muscles, in which the head and neck are turned sideways, forward, or backward, according to the muscles affected. In rare instances it may arise from disease or displacement of the cervical vertebra), and may then be congenital; the distortion may be produced by the contraction of cicatrices after burns, and by tumors. The disease is almost always muscular in its seat; an uncommon form arises from paralysis of the muscles of the opposite side, which may be temporarily corrected without pain to the individual, and should be treated by electricity and the usual remedies employed for paralysis; it may also be rheumatismal, pain being increased or excited by motion, and that position being assumed in which the greatest ease is obtained. It is generally of short duration, and is to be treated like other muscular rheumatism. It is sometimes inflammatory or neuralgic; the former is occasionally noticed in weak children, and the latter in adults after tic douloureux; both are to be treated by rest, leeches, fomentations, and narcotic applications.
The most usual form is the chronic wryneck caused by contraction of the sterno-mastoid muscles, in which the head is bent to one side (generally the right), and the face to the opposite, the right eyebrow and right corner of the mouth being elevated; the whole neck is distorted on the first dorsal vertebra in the direction opposite to that of the head and neck, requiring mechanical after the surgical treatment. Formerly this deformity was treated by tonics, various internal and external remedies (such as stimulating ointments and liniments), and mechanical contrivances; but, since Guérin (in 1838) first drew special attention to the subject, tenotomy or subcutaneous division of the tendons of the contracted muscles has been regarded as the remedy to be alone depended on. The usual operation is the division of the tendon of the sterno-mastoid muscle about half an inch above the sternal insertion, and is performed in a few seconds, without danger, pain, or loss of blood; it is sometimes necessary to divide the fibres of the trapezius and platysma myoides muscles.