Etiology, pattern, and treatment of nose fractures

Abstract

Background: Determining the etiology, epidemiology, pattern, and treatment of nasal bone fractures and the associated soft tissue injuries in a population will be beneficial for the prevention, rapid and correct diagnosis, and adequate management of this pathology in order to minimize postoperative complications. Patients and Methods: This study retrospectively evaluated the patients admitted and treated for nasal bone fractures in a university clinic of oral and maxillofacial surgery in Romania over a 10-year period. Following statistical analysis, evaluation and correlation of the monitored variables, a P value < 0.05 was considered statistically significant. Results: Nasal bone fractures had the highest incidence among men (88.30%), aged 20–29 years (33.33%), with no education (33.33%), interpersonal violence being the main cause in this category of patients (P = 0.004; P = 0.005; P = 0.005). In urban environment (55.9%), nasal bone fractures through aggression and road traffic accidents were predominant, while in rural areas (44.10%), those caused by domestic accidents and animal attacks prevailed (P = 0.551). Nondisplaced (81.10%), closed (85.60%) and involving the nasal septum fractures (51.35%) were preponderant. Hematoma was the most frequent associated soft tissue injury (86.49%), its incidence being increased in the case of displaced (P = 1.000) and open fractures (P = 0.692). The most frequent treatment method was close nasal reduction (CNR) + closed septoplasty (51.35%). The most frequent complication was malunion (7.2%), secondary to CNR without septoplasty (P = 0.037). Conclusions: The main etiology of nasal bone fractures was interpersonal violence, which mainly affected men, aged 20–39 years, with a low level of education, living in urban areas. Implementing laws to fight interpersonal aggression and increase the education level of the population would lead to a considerable reduction in the incidence of this pathology. Patients treated by CNR + closed septoplasty and ORIF had the best postoperative evolution. Immediate septoplasty in the case of associated septal fractures significantly decreased the rate of postoperative complications.

Patterns of Facial Fractures and Associated Soft Tissue Injuries: A Retrospective Study on 1007 Patients

“…Regarding this, the literature reports the fact that injury due to a blow with a fist more frequently results in mandibular fractures or zygomatic bone disjunction, while road traffic accidents and firearm or explosive injuries predominantly lead to midface, comminuted or panfacial fractures ( 3 - 6 , 10 - 12 ). The high incidence of maxillofacial injuries by fist blows, as well as the legislative norms that forbid possession of firearms in our geographical area can explain the great number of mandibular fractures registered in this study ( 13 ). In the midface, zygomatic bone fractures had the highest incidence in the present study.…”

“…The interrelationship between orbital fractures and zygomatic bone fractures is well known, the zygomatic bone being part of 2 of the 4 orbital walls [1][2][3][4][5] . In this context, these two categories mostly overlap; authors may include orbital fractures in the category of zygomatic bone fractures and vice versa 13 . For example, in this study, frontozygomatic fracture was included in the category of zygomatic bone fractures.…”

Patterns and Characteristics of Midface Fractures in North-Eastern Romania

“…A study that analyzed the clinical patterns and characteristics of midfacial fractures over a period of 10 years, this time in the western Romanian population, found that the most common types of fracture were laterofacial (50%) and nasal bone fractures (22.93%), with LeFort type fractures being the least encountered, representing 0.83% for LeFort type I, 1.03% for LeFort Type II and 0.83 for LeFort type III from a total of 397 patients [ 13 ]. Another study from the same part of the country found that midface fractures affect most commonly the male sex and patients from the urban area (54.35%) aged between 20 and 29 years old, with the most incriminated etiology being assault, followed by fall trauma and road traffic accidents [ 14 ]. The fact that the second most incriminated etiology from the north-eastern part of the country is road traffic accidents, and for the western part is accidental falls could be explained by a more developed transport infrastructure in the western part of the country.…”

Repercussions of the COVID-19 pandemic on the epidemiology of facial fractures: a retrospective cohort study

“…Trauma is among the main causes of death and morbidity in the world, according to data from the World Health Organization, and is considered a public health problem [ 1 , 2 ]. Injuries to the head and face may be responsible for 50% of all traumatic deaths when associated with other injuries such as cervical, abdominal, thoracic, and brain trauma according to more recent research [ 3 – 5 ].…”