title: Accuracy of the tongue blade test in patients with suspected mandibular fracture.
abstract: The inter-observer reliability and accuracy of the tongue blade test (TBT) for the identification of patients with mandibular fracture was prospectively evaluated using radiographic diagnosis as the gold standard. A consecutive sample of 110 patients presenting to the emergency department of a teaching county hospital was studied. Patients with uninterpretable x-rays, known diagnosis of mandibular fracture, or inability to cooperate for the test were excluded. Bilateral ability to crack a wooden tongue blade held between the teeth was scored as a negative test. Fifty-three patients had mandibular fractures. In the study group, the TBT had a sensitivity of 95.7%; a specificity of 63.5%; a positive predictive value of 66.2%; a negative predictive value of 95.2%; and an accuracy of 77.3%. The TBT provided contributory evidence useful in screening patients for mandibular fracture.
authors.affiliation: Department of Emergency Medicine, Kern Medical Center, Bakersfield, California 93305, USA.
authors.forename: L L
authors.initials: LL
authors.lastname: Alonso
authors.forename: T B
authors.initials: TB
authors.lastname: Purcell
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity