The research was aim to investigate different treatment methods for hinge fracture with laminae displacement in open door laminoplasty and its effect on postoperative efficacy. From May 2013 to September 2018, 319 patients with cervical spondylotic myelopathy were treated with open door laminoplasty in our hospital, among of them, 63 patients occurred hinge fracture with laminae displacement. Patients were divided into two groups according to the treatment methods. Reconstruction group (35 cases) accepted imbricate reconstruction combined with titanium plate fixation, and resection group (28 cases) accepted lamina resection. The intraoperative indicators were recorded and compared. The neurological function (JOA score), cervical curvature index (CCI), cross sectional area of posterior cervical muscles and axial symptoms were observed. There was no significant difference in terms of operative time and bleeding volume between the two groups (P> 0.05). The cross-sectional area of the posterior cervical muscles in both groups was significantly reduced compared with the preoperative level (P <0.05), but the decline degree in reconstruction group was significantly lower than that in the resection group (P <0.05). The CCI in the reconstruction group was maintained well after surgery (P> 0.05), but in resection group, it was significantly lost (P <0.05). The JOA scores in both groups was significantly increased after surgery (P <0.05), and there was no significant difference between the groups at different time point (P> 0.05). The occurrence of axial symptoms was 8.6% (3/35) in reconstruction group and 21.3% (6/28) in resection group (P <0.05). The hinge fusion rate at 3 and 6 months after surgery was 81.6% (31/38) and 94.7% (36/38), respectively. For patients with hinge fracture and laminar displacement, imbricate reconstruction combined with titanium plate fixation will not affect the recovery of neurological function, but hinge reconstruction is more conducive to the maintain the cervical curvature and reduce the atrophy of the posterior muscles, thereby reducing the occurrence of axial symptoms.