# Complications and complaints in craniofacial fractures – Finnish national data for 20 years

## TL;DR

This study examines malpractice claims related to craniofacial fractures in Finland over 20 years, finding that delayed diagnosis often leads to permanent harm.

## Contribution

The study identifies delayed diagnosis as a major cause of malpractice claims and permanent harm in craniofacial trauma cases.

## Key findings

- Delayed correct diagnosis was the leading cause of malpractice claims (63.2%).
- Permanent harm occurred in 23.1% of patients with craniofacial fractures.
- Delayed diagnostics were associated with 65.3% of facial trauma cases.

## Abstract

Research on reasons for malpractice claims in oral and maxillofacial surgery is scarce. The aim of this study was to investigate the causes and prevalence of permanent harm among craniofacial fracture related malpractice claims.

A retrospective register study was designed and implemented. All patients with a complaint and a diagnosis of facial or cranial fracture were included. The main outcome was the presence of permanent harm, and the predictor variable was the cause of complaint. Chi-square test was used for estimation of statistical significance.

Delay in correct diagnosis was the leading cause of malpractice claims (63.2%), and permanent harm was found in 23.1% of the population. 82.4% of injuries were facial fractures in total population. 65.3% (n = 98) of facial trauma were related with delayed diagnostics (p < 0.001). Permanent harm was more frequent in patients with delayed diagnosis (71.4%) than those without (60.7%, p = 0.299).

Claims of craniofacial trauma are related with under-diagnostics, and un-diagnosed facial fracture can lead to a high rate of permanent harm. Systematic clinical evaluation and facial trauma specialist consultation is recommended to set early correct diagnosis for and improve treatment of craniofacial trauma patients.