Objectives: The purpose of this study was to compare the long-term treatmen
t results of open reduction and rigid internal fixation (ORIF) with closed
reduction and maxillomandibular fixation (CRMMF) for subcondylar fractures
when guided by specific indications and contraindications.
Patients and Methods: A protocol for the treatment of condylar process frac
tures was developed that included absolute and relative indications and con
traindications as well as a technique regimen. To evaluate the results of t
his protocol, 10 patients treated with CRMMF and 10 treated by ORIF were re
called after a minimum of 6 months and examined for gender, race, diagnosis
, age at injury, time since operation, and cause of the fracture. Each grou
p was assessed by 2 blinded investigators for maximum interincisal opening,
right lateral excursion, left lateral excursion, protrusive movement, devi
ation on opening, scar perception, motor function, sensory perception, cont
our perception, occlusion, and perception of pain. Nonparametric data were
compared for statistical significance with a chi-square analysis and parame
tric data with an independent samples t-test (P < .05).
Results: No statistically significant differences existed between the ORIF
and CRMMF groups for gender, race, diagnosis, or cause. Moreover, no differ
ences existed for age at injury, maximum interincisal opening, right latera
l excursion, left lateral excursion. protrusive movement, deviation on open
ing, or occlusion. Differences were noted between groups for time since ope
ration, scar perception, and perception of pain. Using the protocol outline
d, there were no differences between the ORIF and CRMMF groups for ranges o
f motion, occlusion, contour, and motor or sensory function. The ORIF group
was associated with perceptible scars. The CRMMF group a-as associated wit
h chronic pain.
Conclusions: Using a treatment protocol, there were few differences in outc
omes between patients treated with CRMMF and ORIF for subcondylar fractures
. <(c)> 2001 American Association of Oral and Maxillofacial Surgeons.