A nasal fracture can happen in many everyday situations. It is an injury that often accompanies athletes, but can also be the result of a road traffic accident. It is characterised by a fracture in the bony or cartilaginous part of the nose. Fractures usually occur on the bridge of the nose or in the septum, the area where the nostrils divide.
The most common cause of a fracture is a sudden blow to the nose. It often co-occurs with other injuries to the face or neck.
Common causes of nasal fractures include:
- blows or kicks to the face during fights;
- car accidents;
- hits to the nose during contact sports (boxing and other combat sports, hockey, football, basketball, etc.);
- falls (e.g. from stairs).
What are the symptoms of a broken nose?
Symptoms of a nasal fracture mainly include:
- nasal pain;
- swelling of the nose;
- deformity of the nose;
- bruising around the nose or eyes;
- nosebleed;
- blockage of the nasal passages;
- breathing problems.
Consequently, a nasal fracture can lead to:
- a change in the appearance of the nose or the tip of the nose;
- hematoma of the nasal septum;
- perforation of the septum or bending of the nose;
- a permanent breathing problem;
- chronic nostril drainage;
- infection of the nose, sinuses or facial bones;
- disorders of the sense of smell (e.g. loss or impairment of smell).
How is a nasal fracture diagnosed?
A broken nose is diagnosed by interviewing the patient about the circumstances of the accident and the symptoms experienced. The diagnosis is confirmed by an imaging examination. X-rays of the nose and, if necessary, of the spine are routinely taken. If damage to the skull base is suspected, a CT scan of the head is performed.
photo: panthermedia
Treatment
First aid
If you do not have symptoms that require immediate medical attention, there are a few things you can do before going to the doctor:
- If your nose is bloody, sit up and lean forward, breathing through your mouth. This will prevent blood from running down your throat.
- If you are not bleeding, raise your head to reduce the throbbing pain.
- To reduce swelling, apply a cold compress or ice wrapped around your nose for 15 to 20 minutes.
- You can take a painkiller to relieve the pain.
Medical treatment
Nasal fractures that do not disfigure the nose and do not cause breathing difficulties do not need to be set. When the nose is significantly altered or the injury has impaired its patency, it may need to be set. This can be done using a closed procedure. The doctor then decides to anaesthetise the nose from the inside and uses instruments to set the bones in place. There may be times when this type of setting is unsuccessful. An open, or surgical, repositioning is then indicated. Closed repositioning can be performed up to one week after the injury. Later, the adhesion that develops makes it difficult to set and a rhinoplasty is usually indicated. This operation is also performed in patients who, despite the setting, have an obstructed nose, a crooked septum after the injury or an unsatisfactory cosmetic result.
