Accuracy of diagnosis of fractures by maxillofacial and accident andemergency doctors using plain radiography compared with a telemedicine system: a prospective study

Ten facial radiographs with fractures and 10 without fractures were viewed by eight oral and maxillofacial surgery (OMFS) and eight accident and emergency (A&E) doctors who were each asked questions about the presence and site of any fractures as well as the quality of the images and diagnostic confidence. Each radiograph was then transmitted over a teleradiology link and viewed by the same OMFS doctors who answered the same questions. The position of the fracture was more accurately assessed using plain radiography. Diagnosis by OMFS doctors using telemedicine was broadly comparable with fracture diagnosis by A&E doctors using plain radiography. Poor quality radiographs and frontozygomatic and infraorbital rim fractures were poorly diagnosed by telemedicine. This telemedicine system was a useful tool to aid diagnosis of most facial fractures. The need for appropriate clinical information is vital. Diagnosis of frontozygomatic and infraorbital rim disruption using telemedicine is less reliable than plain radiography.