Open versus Closed Treatment of Fractures of the Mandibular Condylar Process: A Prospective Randomised Multi-Centre Study

Abstract

Selecting between open and closed treatment of mandibular condyle fractures is still controversial, though many studies have attempted to clarify this problem. Open reduction and internal fixation seem to obtain better results, but one has to consider the difficulties of the surgical approach and the risks of the operation. An international prospective and randomised multicentre study assessed the results of open versus closed treatment of moderately displaced condylar fractures. Objective parameters such as radiographic measurements, clinical, functional and subjective parameters such as visual analogue scale for pain, and the Mandibular Function Impairment Questionnaire index for dysfunction were evaluated. With regard to the radiographic results there was no statistical differences found between the two groups before treatment. Due to the different approaches in the open treatment, a correction of the disc position and tightening of the articular capsule is possible and could improve functional results compared to the open treatment of condylar neck fractures.