Analysis of Simple Nasal Bone Fracture and Interpreting Results of Closed Reduction under Local Anesthesia

Abstract

Objective: To analyze the age, gender and the most frequent causes of nasal fractures evaluated in the otorhinolaryngology service of a tertiary hospital and interpreting the result of closed reduction of nasal bone fracture under local anesthesia and need for revision surgery.Study design: Prospective case study. Materials and methods:The prospective analysis of 60 patients diagnosed as simple nasal bone fracture over a period of 6 months (between Jan 1st 2011 and July 1st 2011) who presented in department of ENT and HNS at Government Medical College, Srinagar. All the patient underwent closed fracture reduction under local anesthesia after proper assess ment and documentation. The patients were analyzed in groups and followed up to period of 6 months. Results:Total of 60 patients (group A) with nasal bones fracture were included in the study, including 48 men and 12 women. The most common age was between 25 and 65 years. Violence was the most frequent cause seen (48%), followed by traffic accidents (35%), 12% of cases were due to sports injury other causes about 5% (fall from their own height and work related injury). After performing closed reduction under local anesthesia, the immediate results were analyzed using linear analog scale. The followup period ranged from 1 week to 6 months. The functional and esthetic outcome of procedure were seen in followup period. Patients in group A1 (80%) were pleased with their results and did not require a secondary surgery 20%. Patients developed a posttraumatic nasal deformity requiring a posttraumatic septorhinoplasty (group A2).

Comparison Of Outcomes Between Early And Delayed Reduction Of Nasal Bone Fractures

“…The mean age calculated was 43. 16 According to Table 3, patients who underwent early nasal reduction had higher mean satisfaction scores on the seventh and fourteenth days (4.22 ± 0.75 and 4.60 ± 0.49 respectively) than those who underwent the Delayed reduction (2.41± 0.82 and 2.93 ± 0.80 respectively). Patients who underwent Early reduction had better mean Pain Intensity scores at 0 (2.37 ± 0.81) 3rd (1.37 ± 0.81), and 7 th post-operative day (0.58 ± 0.49) than the Delayed reduction at 0(5.83 ± 1.20),3rd (5.08 ± 0.67), and 7thday (4.31 ± 0.58) as shown in Table 2.…”

“…Closed reductions should generally be performed between 3 and 10 days following the trauma. 16 Early treatment of the nasal fractures is associated with improved outcomes and fractures can be reduced satisfactorily up to 2 weeks after the trauma. 17 In previous studies patient satisfaction was higher for mildly displaced fractures if reductions were performed within the proper time In a study by Sharma et accomplished among 2-3 weeks, 3-4 weeks, and 4-5 weeks, accordingly.…”