Nasal Fracture

Risk Factors

Risk factors for a broken nose include:

• Lifting weights without a spotter
• Riding a bicycle
• Riding a motorcycle
• Not wearing safety gear when playing contact sports
• Not wearing a seatbelt when in a motor vehicle
• Participating in a physical fight

Diagnosis

A healthcare provider can usually diagnose a broken nose with a physical examination. In cases where other fractures are suspected or where swelling makes the diagnosis uncertain, the healthcare provider may request imaging studies such as an x-ray or CT scan.

In some cases, a specialist ear, nose, and throat (ENT) doctor may be required. They may use a camera with a wire to inspect the nasal passages. This is usually done after the initial swelling has gone down.

Complications

Complications of a nasal fracture can include:

• Neck injury – depending on the activity which caused the nasal fracture, a neck injury is also possible.
• Deviated septum – the septum is the thin wall which divides the nose into two nostrils. If the nasal fracture causes a crooked septum, this can then cause narrowing of the nostril. This can then affect breathing.
• Septal haematoma – blood pooling in the septum. This must be promptly drained to prevent further problems, such as developing a hole in the septum or the bridge of the nose collapsing.
• Cartilage fracture – sometimes the cartilage surrounding the nose is fractured in addition to the bone.
• Dental injury
• Injury to other bones in the face

Treatment

Treatment options depend upon the severity of the fracture.

In mild cases, ice and painkillers may be recommended to help with symptom relief while the nose heals.

In more severe cases, a healthcare provider may need to perform manual realignment. This is where they straighten the person’s nose using anaesthesia (either local or general, depending on the case). After realignment, the nostrils are usually packed with gauze. Dressings on the outside of the nose or a splint may also be used.

The most severe cases require surgery. This will be performed by an ear, nose, and throat consultant with general anaesthesia. The two types of surgery are:

• Rhinoplasty – reshaping the bones of the nose.
• Septoplasty – reshaping the septum so that neither nostril is blocked.

Prevention

The mainstay of prevention is wearing all recommended safety equipment, including face guards, when playing contact sports. Wearing a seatbelt at all times while in an automobile (including drivers and all passengers) is also very important. Wearing a helmet when riding a bicycle or motorcycle reduces the risk of all types of head injuries, including nasal fracture. Being aware of surroundings reduces the possibility of falls or walking into a stationary object.