Outcomes of Open, Percutaneous, and Closed Treatment of Isolated Mandibular Condylar Fractures

Objectives Mandibular condylar fractures are common facial fractures, and the optimal balance between open and less invasive treatment remains debated. Readmission provides a reproducible hospital-utilization outcome that can be examined in large administrative datasets. This study aimed to compare 30-day readmission following open, percutaneous, and closed treatment of mandibular condylar fractures (MCF) using national inpatient databases. Methods We performed a retrospective database study using the 2016 Kids' Inpatient Database (KID) and the 2019-2020 National Readmissions Database (NRD). KID was used only for supplemental pediatric inpatient characterization and was not used to calculate readmission. The 6,240-case analytic cohort and all 30-day readmission analyses, including the pediatric subgroup analyses, were derived from the 2019-2020 NRD. Isolated MCF were identified with ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) diagnosis codes, and treatment was classified with ICD-10-PCS (Procedure Coding System) procedure codes as open, percutaneous, or closed. Pearson chi-square tests were used for categorical comparisons, with 95% confidence intervals and Cramer's V reported for effect size. A two-sided p < 0.05 was considered statistically significant. Results A total of 6,240 NRD index cases met the study criteria. After correction of denominator and decimal-place transcription errors in the prior version, approach-specific 30-day readmission rates ranged from 4.8% to 8.3% across All Patient Refined Diagnosis-Related Groups (APR-DRG) severity strata. No significant differences were identified among open, percutaneous, and closed approaches within severity strata (all p ≥ 0.711). Age- and fixation-stratified analyses similarly showed no consistent difference between internal and external fixation; pediatric readmission results represent the pediatric subset of the NRD and do not include KID encounters. Conclusion No treatment approach demonstrated a consistent 30-day readmission advantage across the examined subgroups. Readmission should be interpreted as a hospital-utilization outcome rather than a direct measure of functional or clinical effectiveness. Treatment selection should remain individualized according to patient and fracture characteristics.