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Broken Nose

Definition


Disease: Broken Nose Broken Nose
Category: Bones, joints, muscles diseases
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Disease Definition:

A break or crack in a bone of the nose is known as a nasal fracture or a broken nose. It usually occurs in the bone over the bridge of the nose.
Motor vehicle accidents that result in facial trauma, physical fights, falls and contact sports are the most common causes of a broken nose.
Pain, swelling and bruising around the nose and under the eyes are some of the signs and symptoms of this condition. Additionally, breathing may become difficult and the nose may look crooked.
In most cases, surgery isn’t necessary to treat a broken nose; instead, procedures will be performed to realign the nose.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Either immediately, or up to three days after the injury, the patient will experience some of these signs and symptoms:

  • Bruising around the nose or eyes
  • Swelling of the nose and surrounding areas
  • Rhinorrhea, which is the discharge of mucus from the nose
  • Feeling like one or both of the nasal passages have been blocked
  • Pain or tenderness, particularly when touching the nose
  • Having difficulty when breathing through the nose
  • Bleeding from the nose
  • Crooked or misshapen nose



In case the nose injury is accompanied by some of the conditions mentioned below, the person should seek immediate medical attention:

  • Difficulty breathing
  • Bleeding that doesn’t stop
  • A head or neck injury that may be indicated by neck pain, severe headache, loss of consciousness or vomiting
  • The drainage of clear fluid from the nose
  • A noticeable change in the shape of the nose that’s not associated with swelling, such as a crooked or twisted nose

Causes:

Nose is the most facial feature at risk of injury because it is the most prominent feature on the face and because it protrudes unprotected from the person’s profile. Studies have shown that about 40% of all facial fractures are broken noses.
A cartilage supports the nose from the front and on the back and bridge; it is supported by a bone. The bones may be cracked or fractured, causing a broken nose in case this framework of bone and cartilage is struck with force.

Some of the most common causes of a broken nose are:

  • Falls
  • Injury from hockey, football or other contact sports
  • Motor vehicle accidents
  • Physical fights, especially those with punches


Activities such as walking into a fixed object or rough, wrestling-type play in children can cause a broken nose.

The risk of a broken nose is increased with any activity that increases the risk of a facial injury, such as:

  • Riding a bicycle
  • Lifting weights, particularly when a spotter isn’t used
  • Contact sports, especially if the person doesn’t wear a helmet with a face mask, such as hockey and football
  • Riding in a motor vehicle, especially if the person doesn’t wear a seat belt
  • Having a physical fight

Complications

Complications:

Some of the complications that may be caused by a broken nose include:

Collection of blood:
In some cases, a broken nose may be accompanied by a condition called septal hematoma, which is the collection of blood. This condition may block one or both of the nostrils. Additionally, to prevent cartilage damage, surgical drainage is necessary.

Neck injury:
Injuries to the neck (cervical spine) may also accompany nasal fractures that are caused by high-velocity injuries, such as those in motor vehicle accidents. In case the blow is strong enough to break the nose, it may also damage the bones in the neck. The patient should immediately see a doctor in case a neck injury is suspected.

Cartilage fracture:
A cartilage fracture may occur in case the nose injury is caused by a forceful blow, such as from an automobile accident. In case the injury is severe enough to require surgery, the surgery will address the cartilage injuries as well as those of the bone.

Deviated septum:
When the thin wall that divides between the two sides of the nose (nasal septum) is displaced to one side narrowing the nasal passage on that side, a deviated septum may occur. Despite the fact that surgery is necessary to correct this condition, but a deviated septum can be managed with medications, such as antihistamines and decongestants.

Treatments:

Professional medical treatment may not be necessary in case the fracture is minor and it hasn’t caused the nose to become crooked or misshapen. In these cases, using ice on the affected area and taking over-the-counter medications may be enough.

HOW TO FIX DISPLACEMENTS AND BREAKS:
One of two approaches could be used in these cases, they are:

Closed reduction:
In a nonsurgical procedure called closed reduction, displaced bones and cartilage may be manually realigned. This procedure shouldn’t be done after 14 days of the fracture.
In this procedure, a nasal speculum is used to open the nostrils, and then special instruments are used to help realign the broken bones and cartilage and to return them to their correct positions. Before this procedure, the patient will be given pain medications, including nasal sprays or local injections.
The nostrils may be packed with moistened gauze strips in case bleeding is associated with the nasal fracture. To prevent infection, these strips contain an antibiotic ointment.

Surgery:
Closed reduction can’t be performed in the cases of severe breaks, multiple breaks or breaks that haven’t been treated after 14 days of the injury. Having surgery to realign the bones and reshape the nose (rhinoplasty) may be necessary.


A type of reconstructive surgery called septorhinoplasty may be recommended in case the break has damaged the nasal septum, causing obstruction or difficulty breathing.

Both of these surgeries are done on an outpatient basis. Considerable swelling and bruising are some of the common side effects of these surgeries, which usually improve significantly after about one week.

Prognosis:

Not Available

Expert's opinion

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