Is open reduction and internal fixation sacrosanct in the management of subcondylar fractures: A comparative study

Abstract

Purpose: This paper is intended to compare and evaluate the better treatment option in the management of subcondylar fractures of the mandible. Materials and Methods: This study included 20 patients who were diagnosed clinically and radiologically to have sustained an isolated subcondylar fracture of the mandible. They were divided into two groups randomly. Group I included 10 patients who underwent treatment by intermaxillary fixation alone followed by active physiotherapy in the form of conservative management. Group II included 10 patients who underwent treatment by surgical intervention for open reduction and internal fixation under general anesthesia following elastic guidance. Factors such as maximal mouth opening, pain scores, and deviation of mandible on mouth opening were taken into consideration and evaluated. Results: It is observed that the patients in Group I had weight loss and restrictions in their social well-being in the early recovery phase, in addition to delay in return to function. In spite of the early return to function, patients in Group II were subjected to all kinds of surgical complications such as transient facial nerve injury, infection, and unesthetic scar. The maximal mouth opening and deviation of the mandible on mouth opening remained almost the same in both groups. Conclusion: A regular follow up of operated patients post trauma is essential to obtain morphological and functional recovery. When the respective advantages and disadvantages of both treatment options were compared and evaluated, it was observed that patients treated by closed reduction had a better clinical and psychological outcome.

Keywords

• closed reduction
• condylar fracture
• open reduction