In the event of delayed treatment, or if a bone fragment is stuck in the canal, open reduction is performed.
In open reduction, the preservation of the periosteum, and peripheral soft-tissue attachments is recommended.
Locate the fracture by palpation or with image intensifier. Make a small longitudinal incision over the fracture. Extend the incision sufficiently for access. Free up one side of the fracture at a time, with minimal dissection.