Open Reduction and Internal Fixation Versus Closed Reduction and Maxillomandibular Fixation of Condylar Fractures of the Mandible: A Prospective Study

Abstract

Introduction: Condylar fracture, the most common fracture in mandible can be managed via two main modalities. The choice between either of the two depends on the displacement in fracture segments, occlusal changes, patient’s adaptability, masticatory complex, dentate/edentate individual and deviation in mandible.
Aim: This prospective clinical study was conductive with an aim to compare conservative and open method in treating mandibular fracture and to evaluate the effectiveness of the same.
Materials and methods: The present study includes 20 patients with age range 16-56 years of condylar and sub condylar fracture. The reports cases were managed by either of the treatment modality based on the indication of the same. The outcomes of both the modalities were discussed on the following parameters: swelling, residual pain, hematoma and malocclusion. All the patients were called for a follow up.
Results: Among 20 reported cases, 8 cases unilateral condylar fracture, 8 unilateral sub condylar fracture, 3 bilateral condylar fracture and 1 bilateral sub condylar fracture. Amongst all, 8 cases were treated via ORIF, 3 cases ORIF with maxillomandibular fixation (MMF), 7 cases conservative approach and 2 cases MMF alone. No patient treated via ORIF showed malocclusion associated complication. The most common approach followed surgically was combined (preauricular + retromandibular). The post operative complications in ORIF group were swelling (40), residual pain (3) and temporary facial nerve palsy (2). The conservative group recorded complications as swelling (3), residual pain (3), malocclusion (4) and temporary facial nerve palsy (1).
Conclusion: The study concluded with the fact that surgical approach to manage fractures are far better than conservative. However, as the dilemma continues, the choice of method still depends on individual and fracture synchronously.