Single view radiographic screening of midfacial trauma.

Sidebottom et al. have previously shown that one occipitomental 15 degrees view (OM15) is sufficient for screening the majority of cases of midfacial injury. This audit study investigates the effect of introducing a one-view OM15 screening policy into the Accident & Emergency department (A&E) of a district general hospital. Six hundred and twenty-one patients had midfacial radiographic screening over a one-year period. Six hundred and one patients had all notes and radiographs available. Only eight required further views to confirm diagnosis. Thirty-eight fractures were diagnosed with two insignificant fractures of the antral wall missed. The cost saving was Pound Sterling 2082.50 for films alone. Eighty hours of radiographer time were additionally saved. There was no increase in referrals to the maxillofacial team. Single-view radiographic screening for midfacial injuries in A&E attenders is both safe and economical. Extrapolated to the UK population as a whole this would amount to a cost saving to the National Health Service of Pound Sterling 500000.