Comparison of Open and Closed Reduction in Subcondylar Fracture

The aim of this study was to evaluate the long term result of open reduction plus rigid internal fixation as compared with that of closed reduction and intermaxillary fixation in the cases of dislocated mandibular subcondylar fracture. Twenty three patients were enrolled into the series, with 12 cases undergoing open reduction and 11 others having intermaxillary fixation alone. Patients treated with open or closed methods were assessed according to the maximum interincisal opening, protrusive movement, deviation on opening, scar quality, motor function, sensory perception, contour change, occlusion and intensity of joint pain. Long term follow-up results revealed that cases treated with closed reduction tend to have suboptimal outcome, especially in cases with axial inclination of the condylar head, intracapsular fractures, dislocation of the condyle from the confines of the glenoid fossa, and their clinical manifestation include symptoms like severe pain, jaw deviation/deflection upon mouth opening or malocclusion. (J Plast Surg Asso R.O.C. 2006; 15:241~250)