Nasal fracture
| Nasal fracture | |
|---|---|
 | |
| Classification and external resources | |
| Specialty | emergency medicine |
| ICD-10 | S02.2 |
| ICD-9-CM | 802.0 |
A nasal fracture, commonly referred to as a broken nose, is a fracture of one of the bones of the nose. Because of the protrusion of the nose from the face and the fragility of the bones of the nose, a broken nose is one of the most common facial injuries, comprising almost 40% of all facial injuries.[1]
Causes
Nasal fractures are caused by physical trauma to the face. Common sources of nasal fractures include sports injuries, fighting, falls, and car accidents in the younger age groups, and falls from syncope or impaired balance in the elderly.[2]
Symptoms
Symptoms of a broken nose include bruising, swelling, tenderness, pain, deformity, and/or bleeding of the nose and nasal region of the face. The patient may have difficulty breathing, or excessive nosebleeds (if the nasal mucosa are damaged). The patient may also have bruising around one or both eyes.
Diagnosis
Nasal fractures are usually identified visually and through physical examination. A priority is to distinguish simple fractures limited to the nasal bones (Type 1) from fractures that also involve other facial bones and/or the nasal septum (Types 2 and 3). In simple Type 1 fractures X-Rays supply surprisingly little information beyond clinical examination. However, diagnosis may be confirmed with X-rays or CT scans, and these are required if other facial injuries are suspected. Although treatment of an uncomplicated fracture of nasal bones is not urgent—a referral for specific treatment in five to seven days usually suffices—an associated injury, nasal septal hematoma, occurs in about 5% of cases[2] and does require urgent treatment and should be looked for during the assessment of nasal injuries.
Treatment
Minor nasal fractures may be allowed to heal on their own provided there is not significant cosmetic deformity. Ice and pain medication may be prescribed to ease discomfort during the healing process. For nasal fractures where the nose has been deformed, manual alignment may be attempted, usually with good results. Injuries involving other structures (Types 2 and 3) must be recognized and treated surgically.[3]
Recovery
Bone Stability after a fracture occurs between 3-4 weeks. Some experts suggest not wearing glasses or blowing your nose during this time as it can affect the bone alignment. Full bone fusion occurs between 4-8 weeks. General activity is fine after 1-2 weeks, but contact sports are not advisable for at least 2-3 months, depending on the extent of injury. Try not to lift anything heavy unless your doctor says its okay. If you have a cast or splint, wear this until your doctor says its okay to take it off. It is recommended that when participating in sports a face guard should be worn for at least 6 weeks post-injury or until a physician states that it is safe.
Self-Care
Do not remove any packing or splints without medical authorisation.
For stuffiness, take hot showers or breathe in steam, this can help break up mucus and dried blood that builds up after surgery or injury.
Nasal medications can be taken with authorisation from a physician, for pain relief over the counter and prescribed oral non-steroidal anti-inflammatories and pain-killers are recommended.
Notes
- ↑ MayoClinic.com. "Broken nose." Retrieved on 2008-10-16
- 1 2 Bremke M, Gedeon H, Windfuhr JP, Werner JA, Sesterhenn AM (November 2009). "Nasal bone fracture: etiology, diagnostics, treatment and complications". Laryngorhinootologie 88 (11): 711–6.
- ↑ Mondin V, Rinaldo A, Ferlito A (May–Jun 2005). "Management of nasal bone fractures". Am J Otolaryngol 26 (3): 181–5. doi:10.1016/j.amjoto.2004.11.006.