Appropriateness of immediate postoperative radiographs after open reduction and internal fixation of simple maxillofacial fractures--a retrospective audit

Aim: Immediate postoperative radiographs are routinely advised by surgeons for treatment of maxillofacial fractures. It is mainly for evaluation of the reduced fracture, alignment of plates, and assessment of occlusion. To scrutinize the requirement of routine postoperative radiography in patients treated by open reduction and internal fixation of fracture. Materials and Methods: The study was conducted retrospectively and radiographs of the patients who had reported to emergency department of our institute because of maxillofacial trauma from 2014 to 2016 were retrieved from the archive of dental radiology department. A total of 147 subjects were treated for 203 simple maxillofacial fractures. Information on age, gender, type of fracture, site of fracture, treatment carried out, and cause of retreatment if any were recorded. The continuous variables (age and number of fractures) were compared using the Mann-Whitney U test, whereas the Fisher's exact test was used to compare categorical variables (gender and type of management). Results: The number of subjects that required re-treatment surgeries was evaluated. Only 13 subjects required re-treatment surgeries. Only in one subject (0.49%), the decision for re-treatment was based exclusively on postoperative radiographs. Six studies from the literature reported that postoperative occlusion can better predict the clinical outcome instead of immediate postoperative radiograph. The results of this study are in accordance with the literature review. Conclusion: Routine immediate postoperative radiograph may not be essential after management of simple maxillofacial fractures. Immediate postoperative radiographs may be indicated for subjects with possibility of complications.