Condylar Fractures Associated with Mandibular Fractures: A Comparative Clinical Study of Open Versus Closed Management

Abstract

Objectives: This study compares outcomes of open reduction and internal fixation (ORIF) versus closed reduction in patients with combined condylar and mandibular fractures.

Methodology: A prospective comparative study was conducted on 120 patients diagnosed via CT with condylar fractures associated with other mandibular fractures. Patients were divided into ORIF (n=65) and closed reduction (n=55) groups. Outcome measures included maximal interincisal opening (MIO), TMJ pain scores, occlusal stability, deviation on mouth opening, and radiographic healing at 6 months. Significance was set at p < 0.05.

Results: ORIF showed significantly superior functional outcomes. Mean MIO at 6 months was 38.4 mm in the ORIF group compared to 32.4 mm in the closed reduction group (p=0.001). TMJ pain scores were significantly lower in the ORIF group across all follow- up intervals (p=0.001). Occlusal stability (92% vs. 74%), deviation on opening (8% vs. 29%), and radiographic healing (82% vs. 71%) all favored ORIF.

Conclusion: ORIF offers significantly improved anatomical and functional results compared to closed reduction in treating condylar fractures combined with mandibular fractures.

Keywords: Condylar fracture, mandible fracture, open reduction and internal fixation (ORIF), closed reduction, malocclusion.