Quality of life of patients with nasal bone fracture after closed reduction

Park, Young Ji; Cheol, Gi; Kwon, Gyu Hyeon; Ryu, Woo Sang; Lee, Kyung Suk; Kim, Nam Gyun

doi:10.7181/acfs.2020.00507

Cited by 7 publications

(5 citation statements)

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“…Closed reduction is often preferred due to greater efficiency, avoidance of general anesthesia, and decreased invasiveness. 5 , 6 To minimize bacterial infection and complications from corrective procedures, antibiotics can be given prophylactically for nasal fractures. Unfortunately, there is minimal available data and guidance regarding antibiotic administration or prescribing practices in facial fractures.…”

Section: Introductionmentioning

confidence: 99%

The Role of Antibiotics in Nasal Fractures after Closed Reduction

Vishwanath

Rhee

Sobti

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Nasal fractures represent the most common fracture in facial trauma. The role of prophylactic antibiotics in these injuries is debated, given low infection rates and demonstrated risks of antibiotics. We studied the isolated effect of prophylactic antibiotics on infection rate in patients with nasal fracture after closed reduction. Methods: Retrospective cohort study of a prospectively maintained facial trauma database was conducted. Demographics, comorbidities, fracture classifications, and management of patients who received antibiotics at the time of closed nasal reduction were compared against those who did not receive antibiotics. Infection rates between groups were analyzed. Multivariate analysis was conducted to control for confounding variables. Qualitative analysis was performed for patients who experienced infection following nasal fracture. Results: A total of 282 patients met inclusion criteria (n = 144, antibiotic; n = 138, nonantibiotic). Six patients experienced infection. There was no difference in infection rate between antibiotic and nonantibiotic groups (2.0% versus 2.2%; P = 0.90). On multivariate regression, antibiotics did not significantly decrease odds of infection (OR 1.7 [0.17–13.6]; P = 0.64). Moreover, patients with open nasal fractures did not have significantly higher odds of infection (OR 1.9 [0.08–20.8]; P = 0.64). Similarly, increasing severity of injury based on Rohrich classification did not significantly impact odds of infection (OR 0.68 [0.23–1.9]; P = 0.46). All six infections were managed at the bedside, with zero infections following operating room management ( P = 0.32). Conclusions: Prophylactic antibiotics do not decrease infection rates following nasal fractures managed by closed reduction. Bedside management may be a risk factor for the development of infection; however, this finding requires further evaluation.

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Section: Introductionmentioning

confidence: 99%

The Role of Antibiotics in Nasal Fractures after Closed Reduction

Vishwanath

Rhee

Sobti

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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“…Treatment modalities for nasal bone fractures vary since it is not a life-threatening medical condition, and patients tend to neglect the aesthetic outcomes of untreated nasal bone fractures. Moreover, patients may refuse closed reduction due to the fear of general anesthesia and the time-consuming burden of hospitalization [ 7 ]. Clinical experience shows that a significant number of patients visit outpatient clinics seeking septoplasty along with rhinoplasty.…”

Section: Discussionmentioning

confidence: 99%

Do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation?

Choi

Hwang

et al. 2022

Arch Craniofac Surg

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Background: Many severe nasal bone fractures present with septal fractures, causing postoperative septal deviation and negatively affecting the patients’ quality of life. However, when a septal fracture is absent, it is difficult to predict whether surgical correction can help minimize nasal septal deviation postoperatively. This study determined whether performing closed reduction on even mildly displaced nasal bone fracture could deter the outcome of septal deviation.Methods: We retrospectively reviewed the data of 116 patients aged 21–72 years who presented at the outpatient clinic and emergency room with fractures of nasal bones only without any involvement of the septum from January 2014 to December 2020. Patients were classified into three fracture type groups: A (unilateral), B (bilateral), and C (comminuted with depression). The degree of septal deviation was calculated by measuring the angle between the apex of the most prominent point and the crista galli in the coronal view on computed tomography images. The difference between the angles of the initial septal deviation and that of the follow-up was calculated and expressed as delta (Δ).Results: Closed reduction tended to decrease the postoperative septal deviation in all fracture types, but the values were significantly meaningful only in type A and B fractures. In the surgical group, with type A as the baseline, type B showed a significantly larger Δ value, but type C was not significantly different, although type C showed a smaller Δ value. In the conservative group, with type A as the baseline, the other fracture types presented significantly lower Δ values.Conclusion: For all fracture types, closed reduction significantly decreased the extent to which the nasal septum likely deviated. Therefore, when a patient is reluctant to undergo closed reduction, physicians should address the possible outcomes and prognosis of untreated nasal bone fractures.

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“…A nasal fracture and its treatment cause pain and decrease quality of life 5 . The nose must be protected from impact for several weeks, causing a notable pause in training.…”

Section: Introductionmentioning

confidence: 99%

“…2,4 A nasal fracture and its treatment cause pain and decrease quality of life. 5 The nose must be protected from impact for several weeks, causing a notable pause in training. Psychological and functional concerns regarding sports have been reported after nasal fracture treatment, which may be represented, for example, as an impact on sport performance, fear of reinjury or functional problems.…”

mentioning

confidence: 99%

Epidemiology and aetiology of sport‐related nasal fractures: Analysis of 599 Finnish patients

Manninen

Klockars

Mäkinen

et al. 2022

Clinical Otolaryngology

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Sports activities cause 15% of nasal bone fractures. 1 Nasal fractures are especially prevalent in team sports, such as basketball, soccer, American football, rugby and baseball, and in martial arts and equine sports. [1][2][3] Similarly to other facial fractures, they are most prevalent among young males. 2,4 A nasal fracture and its treatment cause pain and decrease quality of life. 5 The nose must be protected from impact for several weeks, causing a notable pause in training. Psychological and functional concerns regarding sports have been reported after nasal fracture treatment, which may be represented, for example, as an impact on sport performance, fear of reinjury or functional problems. 3 Despite treatment, nasal fractures may later lead to impaired nasal breathing and aesthetic disadvantage. 6 Our aim was to study the occurrence, characteristics and injury mechanisms of sport-related nasal fractures. | MATERIALS AND METHODSThe STROBE reporting guidelines were used in manuscript preparation. | Design and participantsIndividuals with nasal fracture were identified from the Helsinki University Hospital (HUH) electronic database for the years 2013-2018 using ICD-10 codes S02.X, and from these individuals, patients with sport-related nasal fractures were selected for further analyses. An inquiry was made to Finnish national sports federations to obtain the total number of athletes training in different team and combat sports. | Statistical analysisStatistical analyses were performed together with an independent professional statistician. The data were analysed using IBM SPSS version 26 and NCSS 12 Statistical Software (2018). A t-test was used to determine significant differences between means, Pearson's χ 2 to compare categorical variables, and crosstabs with pairwise z-test with Bonferroni correction to analyse categorical variables between different sports groups. Statistical significance was set at p ≤ .05. | Ethical considerationsInstitutional research permission was granted from HUH. No Research Ethics Board review was required.

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Quality of life of patients with nasal bone fracture after closed reduction

Cited by 7 publications

References 9 publications

The Role of Antibiotics in Nasal Fractures after Closed Reduction

The Role of Antibiotics in Nasal Fractures after Closed Reduction

Do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation?

Epidemiology and aetiology of sport‐related nasal fractures: Analysis of 599 Finnish patients

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