Management of Nasal Fractures

Abstract

The nasal bones are the most commonly fractured bones in the body. Accurate diagnosis and appropriate surgical intervention are key in the management of nasal fractures. While these injuries are not life-threatening, mismanagement of nasal fractures can lead to both aesthetic and functional deformities. A thorough history and careful physical examination are adequate for the diagnosis of nasal fractures. Literature in the field does not support the use of x-ray films to aid in the diagnosis. The majority of injuries are seen after significant edema becomes present and cannot be accurately reduced at that time. Therefore, with the exception of grossly displaced fractures, open fractures, and septal hematomas, most nasal fractures should be definitively treated after 3 to 10 days once swelling has resolved. This article will review pertinent nasal anatomic structure, pathophysiological characteristics of nasal fractures, diagnostic techniques, treatment modalities, and common controversies associated with nasal fractures.

Broken noses for the gods: ritual battles in the Atacama Desert during the Tiwanaku period

“…In addition, the fragments can rarely be reduced to the original position or stabilized, thus resulting in badly aligned healing, with aesthetic and functional consequences. On the other hand, there is a high incidence of morphological anomalies in the nasal bones, so that radiography is not an efficient technique for fracture diagnosis (Rubinstein & Strong 2000). More severe and lateral traumas force the nasal bones, creating additional fracture lines at the lateral borders of the nasal aperture.…”

A Study of External Nasal Splints used in Nasal Bone Fractures and Rhinoplasties

“…14 Nasal bone fractures are not life-threatening but mismanagement of nasal fractures can lead to both cosmetic and functional deformities. 14 In our country, nasal bone fracture amounts to grievous hurt, so all these are recorded as medicolegal cases.…”

Rendimiento de la evaluación clínica en el diagnóstico de fractura de huesos propios nasales

“…Varios estudios han demostrado que el diagnós-tico de fractura de huesos propios nasales puede ser realizado correctamente sólo con la evaluación clínica 5,6 . Por ejemplo, la presencia de epistaxis después de un trauma nasal ha demostrado estar asociada con un riesgo signifi cativamente mayor de deformidad nasal externa 11 .…”

“…Aunque la fractura nasal es considerada a menudo una lesión de menor importancia, un diagnóstico inadecuado y manejo tardío pueden producir importantes defectos funcionales y estéticos 3,4 . El diagnóstico preciso de las fracturas nasales depende de una historia clínica y examen físico oportunos y completos 5,6 . Los pacientes suelen presentar una combinación de epistaxis, equimosis, deformidad, dolor, edema, la inestabilidad, y crepitación, sin embargo, estas características no siempre pueden estar presentes 7 .…”