Torticollis treated by division of the sterno-mastoid through an open wound / by H.A. Lediard.
- Lediard, H. A. (Henry Ambrose), 1847-1932.
- Date:
- [1894?]
Licence: Public Domain Mark
Credit: Torticollis treated by division of the sterno-mastoid through an open wound / by H.A. Lediard. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![scapula is two and a half inches from the spine. Seeing that the notes of the points of asymmetry were taken fourteen mouths after operation, it is probable tliat had they been taken prior to operation or immedi- ately thereafter, in some respects the deformity of the spine would have been even greater. On May 22, a curved incision was made beneath the inner end of the collar-bone, about three and a half or four inches long, with the convexity downward. Reference to the wood-cut will show the scar resulting. The flap was turned up and the attachments of the muscle to the sternum and clavicle thoroughly exposed. After division of the sternal tendon, it was seen that the clavicular fibres were spread out to at least two inches in breadth, and lay immediately in contact with the subclavian vein, so that it was needful to pass a director beneath the muscle prior to cutting the deep fibres. This having been done, the muscle retracted about one and a half or two inches, and the head w^as brought into a straight position with- out difficulty. The flap was then stitched down, but, owing to air having lodged in the space left by the retracted muscle, an abscess formed which re- quired incision above the collar-bone. With this exception, union of the wound was rapid, and but little gen- eral disturbance was associated with the operation. The head, moreover, retained its new position without any retentive apparatus of any kind. Prior to the lad being discharged, and in order to obviate tlie effect of reunion of the muscle, a leather collar was made by a saddler to keep the chin elevated. It is now more than a year since the operation was performed, and sufficient time has elapsed to enable a judgment to be passed on the result. The asymmetry of the features is the same, but the head is per- fectly straight, although the collar has long since been too small to have any controlling power on the chin. Reference to the wood-cut will show that a few strands of muscle at the site of the operation have formed slender ridges beneath the skin, but this reunion of the muscle does not seem likely to bring about a recurrence of the deformity. Objections to the operation may be raised on account of the extent of skin divided and the scar resulting, which might be a ])lausible reason Lad of fifteen upon whom division of tlie sterno-mabtoid muscle was per- formed, for the correction of torticollis, through an open wound.](https://iiif.wellcomecollection.org/image/b22271648_0008.jp2/full/800%2C/0/default.jpg)
