Carenotes > Nasal Fracture In Children

Nasal Fracture In Children

GENERAL INFORMATION:

What is a nasal fracture? A nasal fracture (FRAK-chur) is also called a broken nose. This occurs when any of your child's bones in the nose are broken. Nasal fractures are the most common facial fractures since the nose is a prominent part of the face.

The nose is the main gate to the respiratory (breathing) system. It warms, moistens, and filters the air that your child breathes. It has two holes called nostrils where air passes going to and out of the lungs. A thin flexible wall called a nasal septum (bridge of the nose) separates the nostrils. The septum is usually damaged in nasal fractures. With proper treatment, care and follow-up, your child has a greater chance of having a full recovery.

What causes a nasal fracture? A nasal fracture in children is caused by an injury or trauma to the nose. This usually happens when a child falls from a high place and lands on his face. He may have fallen from a bed or down the stairs. Most injuries occur while the child is playing. A direct blow to the nose may also cause a nasal fracture. This may occur during a fight, physical abuse, car accident, or in contact sports.

What are the signs and symptoms of a nasal fracture? Your child may have one or more of the following:

• Blockage of one or both nostrils.
  
  
• Clear fluid discharge from his nostrils.
  
  
• Cut, bruise, swelling, or bleeding in his nose, or bruising around his eyes (black eyes).
  
  
• Deformed nose, or nosebridge that is moved towards one side of the face.
  
  
• Grating sound or feeling when the nose is touched or rubbed.
  
  
• Headache, or pain on his nose or face.
  
  
• Trouble breathing, smelling, or talking.

How is a nasal fracture diagnosed? Your child may need one or more of the following:

• Nasal endoscopy: This test, also known as anterior rhinoscopy, uses a scope to see the inside of your child's nose. A scope is usually made of a long, bendable tube with a light on the end of it. During a nasal endoscopy, pictures are taken by a small camera attached to the scope.
  
  
• Nasal speculum exam: Caregivers will use bright light and an instrument called speculum to check the inside of your child's nose. This gently spreads open his nostrils to look for any blood clots or swelling.
  
  
• Other tests:
  
  
  • X-rays: Your child may need to have x-rays of his nose, face, and head taken to check for broken bones or other problems.
    
    
  • Computerized tomography scan: This is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your child's nose, face, and head. Your child may be given a dye before the pictures are taken. The dye may help your child's caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your child's caregiver if he is allergic to shellfish, or has other allergies or medical conditions.
    
    
  • Magnetic resonance imaging scan: This test is also called an MRI. An MRI uses magnetic waves to take pictures of your child's nose, face, and head. During an MRI, pictures are taken of his bones, brain or blood vessels. He will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This may cause serious injury.

How is a nasal fracture treated? Treatment will depend on the damage and the type of fracture your child has. Most nasal fractures heal more rapidly among children than in adults. The younger your child is, the faster the fracture will heal without further problems. Your child may need one or more of the following:

• Closed reduction: Caregivers may realign the broken bones or bring the nose back to its original position. This is done by moving the nasal bones and septum without opening the skin.
  
  
• Device: Your child's nose may need to be fixed or supported with splints. A splint may be placed inside or over the top of his nose.
  
  
• Irrigation and debridement: This is done when the nasal fracture has an open wound. This cleans and removes objects, dirt, or dead tissues from the fracture area.
  
  
• Medicines: Caregivers may give your child medicine to help ease his pain. Your child may need antibiotic medicine or a tetanus shot if the bone has broken through his skin. Medicines may also be given to decrease swelling in your child's nose and make breathing easier.
  
  
• Nasal packing: Caregivers may pack your child's nose with gauze (bandage) strips to control bleeding and prevent infection. These strips are moistened (wet) with salt solution or antibiotic ointment.
  
  
• Surgery: Your child may need surgery to return the bones to their normal position if the fracture is bad. Surgery may also be needed to correct a deformity or fix damaged tissues on the nose. Blood clots in the nose may be removed by making a small incision (cut) in your child's nose. Injury to the other parts of the nose, nerves, or blood vessels may also be treated with surgery.

What first-aid should be done for a nasal trauma? You may do the following if your child has a nasal trauma:

• Have your child breathe through his mouth and lean forward to keep blood from going down the back of his throat.
  
  
• Ice may be applied on the swollen part to decrease swelling, pain, and redness.
  
  
• If your child's head is bleeding, apply a direct pressure with a clean cloth. Place another cloth if the original cloth gets soaked with too much blood.
  
  
• Do not try to straighten or realign the broken nose yourself.

How can a nasal fracture be prevented?

• Always put your child in a car safety seat in the back seat. Do not start the car until your child's seat belt is fastened. If your child is old enough, have him wear a seat belt when driving or riding in a car.
  
  
• Do not leave your baby alone on the bed, changing table, or couch. Place him in a crib or playpen if you must leave him unattended.
  
  
• Do not let your child dive in a shallow pool area or in water where the depth is not known.
  
  
• Make sure your child wears proper padding and protective gear when playing sports. These include helmets, mouth guards, wrist guards, and kneepads that meet safety standards. Teach your child about following safety regulations. Ask your caregiver for more information about bicycle helmet safety.

Where can I find support or more information? A nasal fracture is a life-changing injury for your child and your family. Accepting that your child has a nasal fracture may be hard. You, your child, and those close to you may feel sad, angry, or frightened. These are normal feelings. Talk to your child's caregivers, your family, or friends about your feelings.

You may also want to join a support group. This is a group of people who had head injuries or had nasal fractures. Contact the following support groups for more information about nasal fracture:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• American College of Surgeons
  633 N. Saint Clair St.
  Chicago, IL 606113211
  Phone: 1-312-2025000
  Phone: 1-800-6214111
  Web Address: http://www.facs.org
  

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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