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Open treatment of condylar base and neck fractures is widely recommended, whereas treatment of condylar head fractures is still controversial and just is removal of osteosynthesis material. In this study, bone resorption and remodelling after open treatment of condylar head fractures were three-dimensionally (3D) assessed and correlated with clinical parameters in a medium follow-up. Of 18 patients with 25 condylar head fractures who underwent open reduction and internal fixation, clinical data and cone beam computed tomography (CBCT) datasets were analysed. Condylar processes were segmented in the postoperative and follow-up CBCT scans. Volumetric and linear changes were measured using a sophisticated 3D-algorithm. In the course after surgery, patients function and pain improved significantly. Low rates of postoperative complications were observed. All 3D measurements showed no significant bone resorption during the follow-up period. Open reduction of condylar head fractures leads to good patients outcomes and low rates of long-term complications. This study underlines the feasibility and importance of open treatment of condylar head fractures and may help to spread its acceptance as the preferred treatment option.