Management of Mandibular Condylar Fractures: A Comparison of Closed versus Open Reduction.

Objective: To compare the closed reduction approach with open reduction (transparotid approach) in the management of condylar fractures for parameters such as postoperative facial nerve injury, trismus, and malocclusion.

Study design: An analytical comparative study. Place and Duration of the Study: Department of Oral and Maxillofacial Surgery, The Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from 10th January 2022 to 1st October 2023.

Methodology: Patients with condylar fractures were included and divided into two groups (30 each) and condylar fractures were managed under general anaesthesia. After obtaining informed consent, condylar fractures were managed with closed reduction (maxillomandibular fixation with Eyelets or Arch Bar) in one group. In the other group, open reduction and internal fixation (ORIF) via transparotid approach were performed. Postoperatively, facial nerve injury was recorded five days after the procedure. Postoperative trismus and malocclusion were recorded three months after the procedure.

Results: Better treatment outcomes in terms of postoperative malocclusion and trismus were recorded for open reduction and internal fixation i.e. transparotid approach as compared to closed reduction. Facial nerve injury was recorded for the initial period in transparotid approach but long-term results among both techniques were comparable.

Conclusion: Transparotid approach in comparison with closed reduction provides good results in the management of condylar fractures.

Key words: Condylar fractures, Open reduction, Closed reduction, Facial nerve injury, Transparotid approach.