ROUTINE POSTTRAUMATIC RADIOGRAPHIC SCREENING OF MIDFACIAL INJURIES - IS ONE VIEW SUFFICIENT

Midfacial injuries are a common reason for attendance at Accident and Emergency (A&E) departments. A&E staff find these injuries difficult t o assess due to limited undergraduate training in maxillofacial examin ation and early tissue oedema which may mask asymmetry. Patients are t herefore referred for facial views' radiographs and commonly three vie ws (OM15, OM30, lateral face) ave taken for screening. We reviewed pro spectively 137 consecutive patients over a 5-month period to determine whether one view (OM15) was sufficient to make a diagnosis in additio n to clinical examination. Eighty-three per cent of patients had an ac curate diagnosis from just the one view, representing a potential savi ng of 55 percent of films taken. There were no fractures missed. The s ensitivity was 87.5 per cent and the specificity was 83 per cent. We w ould suggest the introduction of a single-view facial radiograph as a safe method of screening for midfacial fracture in A&E patients where the clinical diagnosis is uncertain and provided there is no cervical injury. This would reduce costs by reducing films taken by over 50 per cent and patients' exposure to radiation. (C) 1996 Elsevier Science L td.