ACCURATE x-ray assessment is invaluable in planning the treatment of maxillofacial fractures. The contemplated surgical approach is influenced by the preoperative physical examination and x-ray film findings. The task of making an accurate x-ray diagnosis prior to surgery is straightforward when fracture lines are visible, large bony fragments are displaced, suture lines are open, and sinus cavities are opaque.
The situation occasionally arises where the physical findings and the x-ray film findings are equivocal or in disagreement. When this problem occurs, small points are sometimes the deciding factors.
In the detailed review of over 300 cases of facial fractures, an interesting radiographic phenomenon has been observed. In the absence of gross radiographic deformity, a fragment of displaced bone can sometimes be seen on edge, producing an abnormal linear density, easily visible on the film. The shadow is produced by a displaced, fractured segment which lies tangential to the x-ray beam,
Merrell RA, Yanagisawa E, Smith HW. Abnormal Linear Density: A Useful X-ray Sign in the Evaluation of Maxillofacial Fractures. Arch Otolaryngol. 1969;90(4):518–525. doi:10.1001/archotol.1969.00770030520022
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