A nasal fracture, commonly referred to as a broken nose, is a fracture of one of the

bone A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...

s of the

nose A nose is a sensory organ and respiratory structure in vertebrates. It consists of a nasal cavity inside the head, and an external nose on the face. The external nose houses the nostrils, or nares, a pair of tubes providing airflow through the ...

. Symptoms may include

bleeding Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethr ...

, swelling, bruising, and an inability to breathe through the nose. They may be complicated by other facial fractures or a septal hematoma. The most common causes include

assault In the terminology of law, an assault is the act of causing physical harm or consent, unwanted physical contact to another person, or, in some legal definitions, the threat or attempt to do so. It is both a crime and a tort and, therefore, may ...

, trauma during sports, falls, and motor vehicle collisions. Diagnosis is typically based on the signs and symptoms and may occasionally be confirmed by plain X-ray. Treatment is typically with pain medication and cold compresses. Reduction, if needed, can typically occur after the swelling has come down. Depending on the type of fracture reduction may be closed or open. Outcomes are generally good. Nasal fractures are common, comprising about 40% of facial fractures. Males in their 20s are most commonly affected.

Signs and 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.

Cause

Nasal fractures are caused by

physical trauma Injury is physiology, physiological damage to the living tissue of any organism, whether Injury in humans, in humans, Injury in animals, in other animals, or Injury in plants, in plants. Injuries can be caused in many ways, including mechanic ...

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.

Diagnosis

Nasal fractures are usually identified visually and through physical examination. In addition, relevant questions to ask the patient include whether there is a noticeable cosmetic deformity and whether the patient has difficulty breathing through the nose after the injury.

Medical imaging Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to revea ...

is generally not recommended. 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 The nasal septum () separates the left and right airways of the Human nose, nasal cavity, dividing the two nostrils. It is Depression (kinesiology), depressed by the depressor septi nasi muscle. Structure The fleshy external end of the nasal s ...

(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. A fracture that runs horizontally across the septum is sometimes called a "Jarjavay fracture", and a vertical one, a "Chevallet fracture". 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 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 (ie, closed reduction) may be attempted, usually with good results. Manually alignment should be performed in adults within 10 days of injury (prior to the bone healing in the misaligned state). For children, bone healing occurs faster, so manual alignment should ideally be performed within 4 days of injury. Injuries involving other structures (Types 2 and 3) must be recognized and treated surgically.

Prognosis

Bone stability after a fracture occurs between 3 and 5 weeks. Full bone fusion occurs between 4 and 8 weeks.

References

External links

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