Comparison of Occlusion in Closed Versus Open Reduction with Internal Fixation in Mandibular Subcondyle Fracture

Abstract

Background: Treatment of mandibular subcondylar fractures has been controversial over years. The treatment modalities devised for such fractures are open reduction with internal fixation and closed reduction. Both have successfully been used over decades, yet the superiority of one over the other is yet to be
assessed. Objective: The objective of this study was to compare, open reduction with internal fixation of mandibular sub-condylar fracture with closed reduction in terms of fine occlusion. Material & Methods: This was a randomized clinical trial conducted at Oral and Maxillofacial Surgery Department, King Edward Medical University & Allied Hospitals, Lahore. 70 patients who presented with unilateral sub-condylar fractures were included in the study. Patients were randomly divided into 2 groups. Group-A patients were treated with closed reduction and immobilization and discharged the same day whereas; Group-B patients were treated by open reduction with internal fixation, and retained in ward for 1 day. Both were recalled for periodic examinations and observation recorded. The objective was to compare both treatment methods in achieving balanced occlusion. Data was analyzed by using Statistical Package for the Social Sciences (SPSS) 20.0. Chi-square was used as test of significance taking p-value <0.05 as significant. Results: At 1st month post-operative, 25(71.43%) Group A & 28(80%) Group B patients achieved fine occlusion and after 3 months fine occlusion was seen in 29(83%) & 33(94%) Group A & B respectively (pvalue= 0.133). Similar results were seen after 6 months. Conclusion: The difference in results of both treatment modalities in terms of occlusion was statistically insignificant. Hence, either treatment is equally good.