We read with great interest the study of Shen et al., entitled “Mandibular coronoid fractures: treatment options”. We congratulate the authors on their work on coronoid fractures.
We do agree that simple and undisplaced fractures of the coronoid can be managed conservatively. The rationale for open reduction and internal fixation (ORIF) is a bit unclear. The article would have been more conclusive if the displaced coronoid fractures had been divided into two groups: a first group in which the coronoidectomy was done and a second group in which ORIF was carried out. The two groups could have been compared with the given parameters of maximum mouth opening, diet function, pain control, and return to normal occlusal relationship. ORIF could have been recommended only if it showed a statistical significance.
The coronoidectomy via an intraoral incision is a simple procedure and is done routinely in numerous procedures, such as oral submucous fibrosis, maxillectomy, and as an autogenous bone graft, without any adverse effects.
The disadvantages associated with ORIF via a modified retromandibular approach are as follows: (1) external facial scar; (2) risk of damage to the facial nerve; (3) increased operation time; and (4) increased costs of plates and screws.
The study could have been more descriptive with regard to the conclusion for coronoidectomy or ORIF. This would help surgeons to choose the correct option and aid in reducing their learning curve.