Comparison of open reduction and internal fixation versus closed reduction and fixation of maxillomandibular joint for the treatment of gunshot injuries of mandible

Objectives: to determine the early and late outcome of two treatment options by open reduction and internal fixation versus closed reduction and maxillomandibular fixation (mmf) in treatment of gunshot injuries of mandible. study design: prospective descriptive study. place and duration:department of oral and maxillofacial surgery king edward medical university/ mayo hospital lahore from november 2008 to november 2009. methodology: sixty patients of gunshot injury were randomly allocated in two groups. in group a,30 patients were treated by open reduction and internal fixation and in group b,30 patients were treated by closed reduction and maxillomandibular fixation. postoperative complications were evaluated fortnightly and the outcome between two group were assessed postoperatively infection,malocclusion,nonunion/ malunion of fracture fragments,facial asymmetry,exposed plate and sequestration of devitalized bone were checked. patients were discharged as the treatment completed and recalled for post operative follow up. results: patients treated by open reduction were having fewer complications as compared to closed reduction i.e. 36.6%,and 50%. p-value (p>0.05) is significant in nonunion,mal union and facial asymmetry. conclusion: based on this study open reduction and internal fixation is the best available method for the treatment of gunshot injuries to the mandibular fractures after gunshot injuries.