Fracture Nasal bones
The nasal bones are the most frequently broken bones in the face. A “broken nose” may have injured bone, cartilage or soft tissue.The nasal bones rigidly support the upper portion of the nose between the eyes. The cartilages are flexible supports that maintain the shape of the rest of the nose. The nasal septum divides the nostrils. The support of the septum is made of both cartilage and bone.
Air traveling through the nose is normally controlled by the position of the cartilages. Bone and cartilages out of place can obstruct the nose. Swelling and clotted blood will also limit the flow of air.
Bruising results from blood spreading into the skin and the underlying tissues. The bruises often migrate around the eyes-black eye- and eventually down the cheeks. The body slowly absorbs this pigmentation. These bruises will usually fade over time.
This X ray shows a broken nasal bone. Although such a text can be helpful, clinical examination in experienced hands may be more valuable. Fractures that are not displaced do not need reduction. Without the radiographs however the patient will not know if nasal protection will be needed.
A nasal fracture may be a part of a more severe injury. There may be other bones injured in the face. The nasal fracture often is treated at the same time as the more severe facial fractures. More severe forms of nasal fractures may need surgery where the bones are realigned and held in place with tiny wires, plates or screws.
Manipulative (Closed) reduction
Sometimes the nasal structures go back into place with a minimum of force. Often a reduction with manipulation and instruments are necessary. A combination of medication inside the nose and injections around the nose lessens the discomfort. If there are other injuries you may need a more extensive evaluation and treatment. Many simple fractures can be reduced in a well equipped office or outpatient setting. More complicated injuries may need reduction under general anesthesia.
