J Korean Assoc Oral Maxillofac Surg.  2014 Dec;40(6):297-300. 10.5125/jkaoms.2014.40.6.297.

Outcomes of open versus closed treatment in the management of mandibular subcondylar fractures

• Kim SY
• Ryu JY
• Cho JY
• Kim HM

• KMID: 1799564
• DOI: http://doi.org/10.5125/jkaoms.2014.40.6.297

Abstract

OBJECTIVES
To compare the clinical and radiological outcomes after closed reduction (CR) and open reduction and internal fixation (ORIF) in the management of subcondylar fractures.
MATERIALS AND METHODS
Forty-eight patients presenting with subcondylar fracture between January 2010 and March 2013 were evaluated retrospectively. Fifteen patients were treated with CR and 33 patients with ORIF. The clinical and radiologic parameters were evaluated during follow-up (mean, 7.06 months; range, 3 to 36 months).
RESULTS
In the CR group, no patients had any problems with regard to the clinical parameters. The average period of maxillomandibular fixation (MMF) was 5.47 days. The preoperative average tangential angulation of the fractured fragment was 3.67degrees, and loss of ramus height was 2.44 mm. In the ORIF group, no clinical problems were observed, and the average period of MMF was 6.33 days. The preoperative average tangential angulation of the subcondylar fragment was 8.66degrees, and loss of ramus height was 3.61 mm.
CONCLUSION
CR provided satisfactory clinical results, though ORIF provided more accurate reduction of the fractured fragment. So there is no distinct displacement of fractured fragment, CR should be selected than ORIF because of no need for surgery.

Keyword

Subcondylar fracture; Closed reduction; Open reduction and internal fixation

MeSH Terms

Follow-Up Studies
Humans
Jaw Fixation Techniques
Retrospective Studies

Figure

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  Fig. 1 Illustration showing the method by which loss of ramus height was measured on the panoramic view. A reference line was drawn through both gonial angles. A perpendicular line between the most superior point of the condyle and the reference line was drawn on the panoramic radiograph. The difference between the non-fractured and fractured side was used as a measure of difference in ramus length.

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  Fig. 2 Illustration showing the method by which tangential displacement was quantified on the panoramic view. A reference line was drawn through both gonial angles, and another line was drawn tangential to the posterior border of the condylar process on each side. The angle between the intersection of the tangent and the condylar process was calculated. The difference in this angle between the non-fractured and fractured sides was used as a measurement of tangential angulation.

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