The existing extraoral approaches cannot meet the aesthetic requirements of the patients with subcondylar fractures well because of visible extraoral scars. Endoscopic-assisted intraoral approach is an aesthetic approach without visible extraoral scars, but it requires expensive equipment and has a steep learning curve, which precludes its use in most hospitals. This study aimed to explore open reduction and internal fixation (ORIF) of subcondylar fracture using a postauricular-groove approach without endoscopic assistant and to assess the aesthetic outcomes and complications.

This retrospective clinical study included 11 consecutive patients with subcondylar fractures who underwent ORIF using a postauricular-groove approach without endoscopic assistant between Jun 2017 and December 2025. The aesthetic outcomes and complications were evaluated.

The mean satisfaction score (0–10) for aesthetic outcomes of incisions was 9.64 ± 0.67 (mean ± SD). Temporary facial nerve weakness was observed in one patient (9.1%), which resolved within 6 months postoperatively. Postoperative auricular anaesthesia was observed in one case(9.1%), and sialocele in another(9.1%). Both resolved within 6 months and 3 weeks postoperatively, respectively.

It appears that ORIF of subcondylar fracture using a postauricular-groove approach without endoscopic assistant is viable and safe, and can meet the aesthetic requirements of patients well. More importantly, without the need for endoscopic assistant, it can be used in most hospitals.