—Using the sartorius muscles of the dog, Middleton1 repeated and confirmed Brook's experiments on the effects of ligation of artery and of vein, together and separately, in respect to the production of ischemic necrosis. The results of these experiments led Middleton to believe that congenital torticollis was due to an ischemic contracture resulting from obstruction (during prolonged childbirth) to the venous return from the sternal head of the sternocleidomastoid muscle. His paper contained a colored photomicrograph of a section from a tumor of the sternocleidomastoid muscle in a child, 4½ months of age, which is almost identical with a section from the sartorius muscle in a dog eight weeks after ligation of the vein only.[Ed. Note.—The causation of congenital torticollis has never been satisfactorily explained. Middleton's studies throw new light on the subject, and point strongly to ischemic contracture as the etiologic factor.
WILSON PD, BROWN LT, SMITH-PETERSEN MN, KUHNS JG, GHORMLEY RK, DANFORTH MS, PERKINS G, VAN DESSEL A, BUCHOLZ CH. FORTY-FOURTH REPORT OF PROGRESS IN ORTHOPEDIC SURGERY. Arch Surg. 1931;22(5):857-874. doi:10.1001/archsurg.1931.01160050168011