• Nose Fracture

    (Broken Nose)

    Definition

    A nose fracture is a break in the bones of the nose.
    Facial Bones
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    Causes

    A nose fracture is caused by a blunt, hard blow to the nose. It often occurs along with injuries to other parts of the nose and face.

    Risk Factors

    Factors that may increase the chance of a nose fracture include:
      Any condition that causes frequent falls, such as:
    • Previous nose fracture or nose injury
    • Participating in sports, especially contact sports
    • Reckless behavior during recreational activities or driving
    • Failure to wear a seat belt —keep in mind that airbags can also sometimes cause injury

    Symptoms

    A nose fracture may cause:
    • Pain in the bridge of the nose
    • Inflammation of the nose or surrounding area of the face
    • Bleeding from the nose (often heavy)
    • Difficulty breathing through the nose or nostril
    • Discoloration of the nose
    • Black eyes

    Diagnosis

    You will be asked about your symptoms and how the injury occurred. Your nose and face will be examined for:
    • Irregularities in the shape
    • Movement of the bones of the nose and face
    • Rough sensation when the nose is moved
    • Pain or tenderness to touch at the nasal bridge
    • Injury to the nasal septum (especially hematoma)
    • Any fluid from the nose, such as blood or cerebrospinal fluid (in severe cases)
    Although not necessary, imaging tests may be done to confirm the fracture, and check its location and severity. They usually are not done until the inflammation goes down. Imaging tests may include:

    Treatment

    Treatment depends on the severity of the fracture. If the nose is broken and in position, the only treatment needed is home care. It is important to be careful to not bump the nose while it heals. More severe fractures may need realignment or surgery.

    Ice

    Ice can be used to help reduce inflammation and pain.

    Medication

    Prescription or over-the-counter medications may be given to help reduce inflammation and pain.

    Realigning the Bones

    If the nose is out of position, obstructing your breathing, or causing other problems, then the doctor may:
    • Drain any blood that may have collected in or around the septum
    • Set the fracture by:
      • Moving the bone back to its normal position after the inflammation has gone down
      • Stabilizing the bone with gauze packing on the inside and a splint or tape on the outside

    Surgery

    Surgery may be needed to set the fracture if:
    • The fracture is severe and will not heal without surgery
    • The nose is severely misshapen
    • The fracture impairs breathing

    Prevention

    Nose fractures may not always be preventable, but you can reduce your risk:
    • Wear protective headgear with face masks when playing contact sports, or when riding a bicycle or motorcycle.
    • Wear a seat belt when driving or riding in a car.
    • Avoid situations that may involve a fight.

    RESOURCES

    American Academy of Cosmetic Surgery http://cosmeticsurgery.org

    Family Doctor—American Academy of Family Physicians https://familydoctor.org

    CANADIAN RESOURCES

    The Canadian Society of Plastic Surgeons http://www.plasticsurgery.ca

    The College of Family Physicians of Canada http://www.cfpc.ca

    References

    Fractures of the nose. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/injuries-poisoning/facial-trauma/fractures-of-the-nose. Updated September 2016. Accessed August 30, 2017.

    Isolated nasal bone fracture—emergency management. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T910337/Isolated-nasal-bone-fracture-emergency-management. Updated August 30, 2017.

    Nasal fractures. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/nasal-fractures. Accessed August 30, 2017.

    Ondik MP, Lipinski L, Dezfoli S, Fedok FG. The treatment of nasal fractures: a changing paradigm. Arch Facial Plast Surg. 2009;11(5):296-302.

    Rother T, Riechelmann H, Gronau S. Secondarily accelerated foreign bodies as a source of danger from airbag deployment. HNO. 2006;54(12):967-970.

    Revision Information

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