title: Routine Postoperative Imaging Is Not Indicated in the Management of Mandibular Fractures.
abstract: OBJECTIVE
  Prior literature has shown that routine postoperative computed tomography (CT) scans for mandibular fractures have no effect on outcomes and complications; however, past surveys have reported that most clinicians continue to order routine scans. We aimed to determine the current use of routine postoperative CT scans, evaluate what factors contribute to this practice, and identify differences in outcomes and complications among patients with either routine, indicated, or no postoperative CT scans.
  
  
  METHODS
  We conducted a retrospective review of consecutive patients treated for a mandibular fracture at Vancouver General Hospital from January 1, 2007, to March 1, 2012.
  
  
  RESULTS
  We included 167 patients in the study for analysis. No significant differences in outcomes or complications were found between patients who had an indicated postoperative CT scan (27%) and patients with no scans (64%). Only the treating surgeon had a statistically significant effect on whether a patient received a postoperative CT scan (P < .001), and those patients who had an indicated postoperative CT scan (9%) were more likely to have a decreased level of temporomandibular joint function (P = .002) and increased incidence of complications and secondary operations (P < .001 and P < .001, respectively).
  
  
  CONCLUSIONS
  Routine postoperative CT scans were found to have no significant effect on outcomes and complications, and a clinician's individual practice was the most significant factor for whether a patient received a routine postoperative CT scan. Future work should aim at providing well-defined indications for postoperative imaging.
authors.affiliation: Clinical Professor, Division of Plastic Surgery, Department of Surgery, University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia, Canada. Electronic address: douglas.courtemanche@ubc.ca.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Courtemanche
authors.affiliation: Private Practice, Melbourne, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Barton
authors.affiliation: Resident, Division of Plastic Surgery, Department of Surgery, The Royal Melbourne Hospital, Parkville, Melbourne, Australia.
authors.forename: Damon
authors.initials: D
authors.lastname: Li
authors.affiliation: Consultant Radiologist and Assistant Clinical Professor, University College Dublin and St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Graeme
authors.initials: G
authors.lastname: McNeill
authors.affiliation: Clinical Associate Professor, Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Manraj K S
authors.initials: MKS
authors.lastname: Heran
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D011182:Postoperative Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*