NASAL FRACTURES, EVALUATION & REPAIR
A nasal fracture is commonly called a broken nose. This is one of the most common fractures to occur in the human body and can range from a minor to a serious injury. Nasal fractures are caused by physical trauma to the face and it is always important to determine if other injuries have occurred in addition to the nasal injury.
The most common symptoms of a nasal fracture include bleeding from the nose, swelling and bruising of the nose, facial, pain, and difficulty breathing through the nose. In many cases the nose will appear deformed but with swelling this feature may be difficult to determine immediately after the injury. Swelling typically resolves after four to five days and it is often best to examine a patient at about this time. It is important to be seen shortly after the injury so that treatment plans can be made because there is a window of opportunity in which repair of the nasal fracture is easiest and will produce the best outcome. In addition to the nasal fracture, the nasal septum may be injured causing nasal airway obstruction or a hematoma within the nose; septal hematomas require immediate treatment and are most common in children. Typically it is best to have an examination of the nose by a nasal surgeon after a serious nasal injury.
During an evaluation for nasal injury you should expect a complete examination of the nose and facial structures. Although the focus of the exam is the nose, it is not uncommon to have other injuries as well. For minor injuries such as contusions or non-displaced fractures, only symptomatic care is required. For a nasal fracture in which the nasal bones are displaced, which means they are no longer in proper alignment, reduction of the nasal bones is typically needed in order to restore the shape, form, and function of the nose.
Most nasal fractures are repaired in an outpatient hospital setting, usually with sedation or anesthesia, but at times they may be repaired in the office. Nasal bones are re-positioned back into their proper alignment and a splint or material within the nose may be required into position the bones while they are healing. A nasal splint is typically left in place for about one week. Strenuous activity, heavy lifting, or contact sports are best avoided for two weeks or until the nose has healed and regained its strength. In the majority of cases a fractured nose can be restored back to the pre-injury state; however, for severe injuries this may not be possible. In patients with delayed treatment it is often very difficult to repair their nasal fractures and they may require re-breaking of their nose in order to mobilize the bone fragments. It is also very important to understand that if your nose was crooked before the nasal injury, it will very likely be crooked after surgery. Performing rhinoplasty to change old nasal deformities and repair of a new nasal fracture at the same time is not usually appropriate because precise control of the outcome is difficult.