Errors in the primary x-ray diagnosis of maxillofacial fractures.

The accuracy in reading of primary maxillo-facial films of 347 inpatients with facial fractures was analysed retrospectively. In all, patients had 438 fractures: 116 nasal, 167 mandibular, 133 mid-facial and 22 upper facial fractures. 68% of all patients were operated. A correct diagnosis in the accident department was made in 322 out of 438 fractures (74%) by a radiologist and in 294 (70%) by a non-radiologist. The accuracy in interpretation of nasal and mandibular fractures was good by both interpreters, but less satisfactory in the assessment of mid-facial fractures. A false diagnosis was made in 23% of cases by a radiologist and in 24% by a non-radiologist, a partially correct diagnosis in 32% and in 42% of cases, respectively. Poor radiographic technique and lack of experience for facial trauma diagnostics from a radiological aspect were the most important sources of error. In general hospitals, special training in the interpretation of maxillo-facial radiograms should be organized.