Facial Bone Fractures
Indications for ED Radiological studies for facial bone fractures are:
- Obvious facial bone fracture or fractures suspected on physical exam
- Facial bone fracture detected on head CT
- Facial bone fracture detected on radiograph from referring facility
- These films are not often needed urgently and should be obtained at the request or discretion of the maxillofacial trauma consultant.
- Facial plain films are sometimes helpful for treatment planning.
- Formal coronal CT is usually only needed when coronal reconstructions do not provide adequate detail for surgical treatment planning.
- An urgent coronal CT may sometimes be needed to resolve an equivocal CT with regards to optic nerve integrity or compression.
- Mandibular Panorex is a useful study in patients who can sit upright and cooperate with the exam.
- Panorex is not often logistically obtainable in multi-trauma patients.
- Axial CT with coronal reconstructions, which provides satisfactory detail for treatment planning, is the usual diagnostic of choice.
Disclaimer
These guidelines are not intended as
a directive or to present a definitive statement of the applicable standard of
patient care. They are offered as an approach for quality assurance and
risk management and are subject to (1) revision as warranted by the continuing
evaluation of technology and practice; (2) the overall individual professional
discretion and judgment of the treating provider in a given patient
circumstance; and (3) the patient’s willingness to follow the recommended treatment.
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