Nasal fracture is a very common injury when receiving facial trauma. Fortunately, its treatment is simple and only requires manual reduction in most cases.
The nose is a structure of bone and cartilage tissue responsible for allowing air to enter and exit the lungs. Due to their anatomical location, the nasal bones are affected more frequently than any other bone in the face. Are you interested in knowing the symptoms, complications and treatments of nasal fracture?
Nasal fracture is the loss of continuity of the bony tissue in the nose that usually occurs from direct trauma. In this sense, receiving a high-energy impact from a blow, a car accident or a fall from a height can trigger a fracture of the nasal bones and damage the surrounding tissue.
This injury is associated with various complications ranging from blood loss to cranial vault involvement. On the other hand, the treatment is oriented towards stabilizing the trauma and realigning the nasal bones.
Main causes of a nasal fracture
Nasal bone fracture is usually the result of activities or events that result in a moderate to high energy impact on the central region of the face. It is estimated that more than 76% of these injuries are due to sports accidents and physical attacks on people.
Similarly, the fracture of the nasal septum and the structures adjacent to the nose are often the result of traffic accidents. In fact, some studies attribute 16% of nasal traumatic conditions to motorcycle accidents and 13% to motor vehicle accidents.
Falls from heights account for more than 20% of the incidence of these injuries. This fracture is very common and can even be caused by hitting a wall or door. In addition, the external and individual factors that condition and increase the risk of a nasal fracture must be considered.
Currently, the prevalence of nasal lesions is higher in males with more than 68% of reported cases. This is due to the type of violent practices and high-energy activities generally carried out by men.
Physical contact sports such as wrestling and martial arts predispose to developing this condition. Similarly, playing rugby or football games also increases the risk of a nasal fracture.
As for traffic accidents, the lack of safety measures is an important risk factor. In this sense, not wearing helmets when riding motorcycles or not wearing a seat belt predisposes to this type of injury due to the high level of exposure of the skull and its attachments to high-speed impacts.
The clinical manifestations of nasal fracture are usually acute. Nasal bleeding or bleeding is the most characteristic symptom of this type of injury. This is the product of the injury and rupture of the mucosa that lines the inside of the nose in most cases.
Bleeding is not the only symptom presented by people with this injury. In this sense, it is common to find the following symptoms in a nasal fracture:
Increased volume of the nasal septum.
Pain and tenderness when touching the nose.
Bruises or bruises around the nose and eyes.
Crooked or deviated nose.
A feeling of blocked or stuffy nose.
Nasal bridge depression.
Translucent fluid outlet through the nose.
When to see a doctor?
In general, all trauma should be evaluated and treated immediately by a healthcare professional. The application of first aid is usually sufficient in most nasal fractures; however, you should seek help from a specialist doctor in the following cases:
Continuous nosebleed that does not stop.
Presence of blood clots in the nose.
Trauma associated with a head or neck injury.
Deformed nose, outside normal limits.
Choking or choking sensation.
Translucent fluid outlet that does not stop.
Loss of consciousness.
Nasal fracture diagnostic tests
Identification of a nasal fracture is made through a physical examination by the physician. In general, the history and acute symptoms tend to aid rapid diagnosis and the application of timely therapeutic measures.
The specialist will examine the nasal pyramid, nasal septum, and nostrils for obvious abnormalities or injuries. Among them are septal hematomas, mucosal lacerations, signs of rupture of the cranial vault and leakage of cerebrospinal fluid.
Through gentle palpation, the physician will recognize irregularities or alterations in the shape and alignment of the nose. In addition, evidence of abnormal movements or the perception of easily displaced bones is of great diagnostic importance.
Complementary imaging methods are rarely used in most people with a nasal fracture. However, if multiple fractures or cervical and cranial injuries are suspected, X-rays or computed tomography can be requested.
Most nasal septum fractures are treated on an outpatient basis, as the main goal is to reduce inflammation and relieve symptoms. However, realignment and repair of the area is chosen when there is bone displacement; In addition, septal hematomas should be drained as soon as possible.
To reduce inflammation and pain, ice packs are usually prescribed for 15 minutes every 2 hours. In addition, oral non-steroidal anti-inflammatory drugs such as paracetamol or acetaminophen are indicated. Resting with the head up also helps to improve symptoms.
On the other hand, the reduction of separated bone fragments is usually postponed for a period of 3 to 5 days. In this way, it is expected that there will be a reduction in the volume of the lesion that favors the medical or surgical approach.
It is performed in the first 2 weeks after nasal trauma in most cases. To do this, the doctor administers a local anesthetic drug that helps reduce pain during manipulation; For their part, children require a general anesthetic that causes temporary loss of consciousness.
The specialist will open the nostrils with the help of a speculum, and then align and fix the bone and cartilaginous fragments. On some occasions, splints are placed to help stabilize the repaired area.
In addition, internal bandages, compresses, and gauze are placed to keep the displaced structures fixed. It is common for antibiotics to be prescribed after the procedure to prevent bacterial infections and possible complications.
Surgical realignment of nasal fracture
Reduction by surgical assistance is indicated in nasal fractures with more than 2 weeks without treatment, in multiple injuries and in patients in serious condition. This is an invasive procedure in which the anatomy and architecture of the nasal bone and cartilage tissue are restored.
Lifestyle and recovery
Nasal fracture patients usually recover after 6 weeks. As in any other trauma, it requires rest and measures for the relief of symptoms, so it is advisable to make some changes in lifestyle and follow the following recommendations:
Follow the doctor’s instructions: when you go to the specialist, do not forget to write down each of the indications and recommendations. In this way, you make sure you have a better evolution of the fracture and reduce the risk of complications.
Use cold or ice compresses: they help reduce inflammation and relieve pain in the area, it is advisable to wrap them with a cloth and avoid direct contact with the skin. Similarly, they should not be applied with excessive pressure, as they could worsen symptoms.
Using pain relievers: In general, drugs are usually indicated to reduce pain and sensitivity in the nasal region. Your doctor may order ibuprofen, acetaminophen, or naproxen depending on the severity of the case.
Rest: it is advisable not to do sports activities during the first 2 weeks of treatment. In addition, the cessation of high intensity physical activities and contact for at least 6 weeks is recommended.
Keep the chin elevated: when sleeping, keep your head up with the chin raised to help reduce bleeding and inflammation.
Protect your nose when doing contact activities
Nowadays, nasal fracture is usually common in people who practice extreme sports or with a high level of physical contact. Therefore, it is essential to use helmets or other facial protection equipment during your practice.
In the event of a high-energy injury to the nose that is accompanied by profuse bleeding, first aid should be applied immediately. While medical help arrives, it is important to keep your chin elevated and breathe through your mouth. In addition, you should see a doctor or as soon as possible if the symptoms do not improve or get worse in a short time.