Nasal fracture

A nasal fracture is a break in one of the bones of the nose. This injury is quite common among all types of facial injuries. In fact, nasal fractures make up about 40% of all facial fractures.

While these injuries can be painful, most people have a good outcome. Doctors focus on ensuring the nose looks correct and functions well for breathing.

When a person suffers a nasal fracture, several physical symptoms often appear. The nose may show visible swelling, bruising, or a change in shape called a deformity. A patient might experience pain, tenderness, or bleeding from the nose. This bleeding is known as epistaxis.

If the nasal mucosa, which is the inner lining of the nose, is damaged, bleeding can be excessive. Some patients may also notice bruising around one or both of their eyes. It may also become difficult to breathe through the nose.

Medical professionals categorize these injuries into three distinct types. A Type 1 fracture is a simple break limited only to the nasal bones. Types 2 and 3 are more complex injuries. These involve the nasal septum, which is the wall dividing the nostrils, or other bones in the face. Within these categories, specific patterns exist. A horizontal break across the septum is called a Jarjavay fracture. A vertical break is known as a Chevallet fracture.

Diagnosing a nasal fracture usually begins with a visual inspection and a physical examination. Doctors will ask if the patient notices a cosmetic deformity. They also check if the patient has trouble breathing. While X-rays can sometimes confirm a break, they are not always required for simple Type 1 fractures. However, medical imaging like X-rays or CT scans is necessary if doctors suspect other facial injuries.

There are several ways these injuries occur through physical trauma. Common causes include sports injuries, fighting, falls, and motor vehicle collisions. The age of the person can change the typical cause. For example, males in their 20s are the group most commonly affected. In elderly populations, falls often happen due to syncope, which is a fainting spell, or impaired balance.

Treatment depends on the severity and type of the fracture. For minor fractures without significant deformity, the nose may heal on its own. Doctors often recommend ice and pain medication to manage discomfort. If the nose is deformed, a doctor may perform a closed reduction. This is a procedure where the bones are manually aligned by hand.

For adults, this should happen within 10 days of the injury. Because children heal much faster, they should receive manual alignment within 4 days.

One critical complication is a nasal septal hematoma. This is a buildup of blood inside the nasal septum. It occurs in approximately 5% of nasal injury cases. Unlike simple fractures, a hematoma requires urgent medical treatment. Doctors must look for this during their initial assessment.

The healing process follows a specific timeline for bone recovery. Bone stability usually occurs between 3 and 5 weeks after the injury. Eventually, the body completes the repair through full bone fusion. This complete fusion typically takes between 4 and 8 weeks.