SURGICAL VERSUS NONSURGICAL TREATMENT OF UNILATERAL DISLOCATED LOW SUBCONDYLAR FRACTURES - A CLINICAL-STUDY OF 52 CASES

To compare open versus closed reduction of unilaterally dislocated low subcondylar fractures in adults, 101 consecutive dentulous patients w ere treated either by closed reduction with a median of 4 weeks of max illomandibular fixation, or with a median of 6 weeks of maxillomandibu lar fixation after surgical repositioning and transosseous wiring of t he dislocated condylar fragment. No selection of patients was done for either treatment. Fifty-two patients were seen at a median of 2 years postoperatively. Complications such as malocclusion, mandibular asymm etry, impaired masticatory f unction, and pain located to the affected joint or masticatory muscles were seen significantly more frequent in patients treated with closed reduction compared with those treated su rgically (P = .005). Neither the degree of dislocation of the proximal fragment, concomitant mandibular fractures, nor the absence of poster ior occlusal support seemed to influence the results.