A quantitative study to determine the efficacy of occipitomental facial views in diagnosing fractures by trauma consultants at an academic hospital in Johannesburg

Abstract

Radiography on patients who sustain facial bone fractures form the largest workload in the trauma department at Charlotte Maxeke Johannesburg Academic Hospital in South Africa. These examinations are performed on patients who are either intoxicated or badly injured thus very little cooperation can be guaranteed. The researchers observed that the trauma consultants make a diagnosis from one or two out of the four projections routinely performed. Depending on the findings from these radiographs, some of the patients are referred for computer tomography (CT); others are managed consecutively. Previous studies on the choice of diagnostic modality to use for facial bone trauma ranged from conventional radiography, CT and ultrasound. METHODS : A retrospective, quantitative, descriptive and cross-sectional study was conducted. Two trauma consultants(#1 and #2) were invited to each analyse 35 plain-film occipitomental (OM) 15° and 35 plain-film occipitomental (OM) 30° images (n=70). The findings of the trauma consultants were related to those of the radiologists, which was estimated to be 90%. RESULTS AND DISCUSSION : Kappa statistics were used to analyse the results. Participant #1 achieved 88.57% and participant #2 achieved 80% for a positive diagnosis. Their assessment of the images were similar to published studies. CONCLUSION : The results indicated that OM 15° and OM 30° radiographs were sufficient as a screening tool for mid-facial bone trauma. Accurate diagnostic information can be obtained from two instead of the four projections currently performed.