The need of postoperative radiographs in maxillofacial fractures--a prospective multicentric study

There is still debate about the appropriateness of taking postoperative radiographs in the management of maxillofacial fractures. We did a prospective, multicentre study with predefined inclusion and exclusion criteria involving seven centres with a minimum sample size of 50 patients from each (total n=431). A standard data sheet was given to operators to record clinical and radiological variables before and after operation. The information obtained was analysed to evaluate the need for routine postoperative radiographs in the management of maxillofacial fractures. Patients were followed up for one month postoperatively. The parasymphyseal (n=240) was the most commonly encountered fracture site. The orthopantograph was the most commonly used radiograph, being recorded in 421 cases (98%) before, and all 305 cases in which it was recommended after, the operation. Assessment of the reduction after fixation was the most common reason (n=237, 78%)) for advising postoperative radiographs. Intraoperative reduction and immediate postoperative occlusion were better indicators (p=0.02 and 0.01) of reduction, fixation, and clinical outcome than immediate postoperative radiographs. The practice of advising postoperative radiographs routinely should be discouraged as it has no significant role in the management of maxillofacial fractures.