Nasal bone fracture

OBJECTIVE: To study fracture nasal bone at King Faisal Hospital University in Al-Khobar from various aspects, to present our experience and to compare the result with previous works.

METHODS: A prospective study conducted from January 1997 to May 1998 including all new cases of fracture nasal bone presented at our emergency department. Plain x-ray of the nose is requested for all patients except one in whom pregnancy is suspected. Reduction of fracture nose was carried out 2-7 days post injury by closed technique under general or local anesthesia with application of nasal cast for 2 weeks. Follow-up of those patients in our clinic is evaluated regarding shape, patency and satisfaction.

RESULTS: Eighty six patients included in our study with peak incidence at age 1-30 years with male being dominant. Fall down and road traffic accidents were the common cause of fracture nasal bone. The common presentation was swelling and tenderness in all patients followed by deformity (30.5%) nasal obstruction (40%), and deviated nasal septum (15%). Negative x-ray finding was noticed in 30%, and computerized tomography scan was required for evaluating complicated cases. Only 30 patients (35%) required reduction by closed technique, 23% had poor outcome and were considered as failure.

CONCLUSION: This paper stresses the importance of early evaluation of fracture nose in order to avoid complications. The diagnosis is made mainly based on clinical judgement. Closed reduction technique under general anesthesia within 2-10 days post injury is the standard treatment if needed. Failure by closed technique can be managed by septorhinoplasty months later.