Routine postoperative imaging is not indicated in the management of mandibular fractures

Publication date: Available online 26 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Douglas J. Courtemanche, Richard Barton, Damon Li, Graeme McNeill, Manraj KS. Heran
PurposePrior literature has shown that routine postoperative CT scans for mandibular fractures have no effect on outcomes and complications; however, past surveys report that the majority of clinicians continue to order routine scans. Herein we aim to determine the current use of routine postop CT scans, evaluate what factors contribute to this practice, and identify differences in outcomes and complications amongst patients with either routine, indicated, or no postop CT-scan.MethodsA retrospective review of consecutive patients treated for a mandibular fracture at Vancouver General Hospital from January 1, 2007 to March 1, 2012 was conducted.Results167 patients were included in the study for analysis. No significant differences in outcomes or complications were found between patients who had an indicated postoperative CT scan (27%) or no scan (64%). Only the treating surgeon had a statistically significant effect on whether a patient received a postop CT scan (p<0.001) and those who had an indicated postop CT scan (9%) were more likely to have a decreased level of TMJ function and increased incidence of complications and secondary operations (p=0.002, <0.001, and <0.001).ConclusionRoutine postoperative CT scans were found to have no significant effect on outcomes and complications, and a clinician's individual practice was the most significant factor for whether a patient receives a routine postop CT scan. Future work should aim at providing well-defined indications for postop imaging.



http://ift.tt/2ik3bB1