Nasal Fracture

GENERAL INFORMATION:

What is a nasal fracture?

• A nasal fracture (FRAK-chur) is also called a broken nose. This occurs when any of the bones of your nose are broken. Nasal fractures are the most common fractures of the face. This happens because the nose is a prominent part of the face.
  
  
• The nose is the main gateway to the respiratory (breathing) system. It warms, moistens, and filters the air that you breathe. It has two holes called nostrils where air passes in 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 treatment, care and follow-up, your nasal fracture can heal, and its symptoms relieved.

What causes a nasal fracture? A nasal fracture is caused by an injury or trauma to the nose. The injury is usually from a direct blow or punch to the nose. This may occur during a fight, physical abuse, car accident, or in contact sports. Most sports injuries occur while playing baseball or basketball, or by getting hit with a hockey puck.

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

• Blood or clear fluid coming from your nostrils.
  
  
• Cut, bruise, or swelling in your nose, or bruising around your eyes (black eyes).
  
  
• Deformed nose or bridge of the nose that is bent towards one side of the face.
  
  
• Headache, or pain in your nose or face.
  
  
• Scraping or grating sound or feeling when the nose is touched or rubbed.
  
  
• Trouble breathing, smelling, or talking due to blocked nostrils.

How is a nasal fracture diagnosed? You may be given a dye before the pictures are taken for some of these tests. The dye may help your 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 caregiver if you are allergic to shellfish, or have other allergies or medical conditions. You may need any of the following:

• Nasal endoscopy: This test, also known as anterior rhinoscopy, uses a scope to see the inside of your 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 nose. The speculum gently spreads open your nostrils to look for any blood clots or swelling.
  
  
• Other tests:
  
  
  • X-rays: You may need to have x-rays of your nose, face, and head taken to check for broken bones.
    
    
  • 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 nose, face, and head.
    
    
  • Ultrasound: An ultrasound is a simple test that looks inside of your body. Sound waves are used to show pictures of your organs and tissues on a TV-like screen.

How is a nasal fracture treated? Treatment will depend on the damage and the type of fracture you have. Most nasal fractures heal rapidly. You may need any 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 nose may need to be fixed or supported with splints. A splint may be placed inside or over the top of your 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 you medicine to help ease your pain. You may need antibiotic medicine or a tetanus shot if there is an open wound. Medicines may also be given to decrease swelling in your nose and make breathing easier.
  
  
• Nasal packing: Caregivers may pack your nose with gauze (bandage) strips to control bleeding and prevent infection. These strips are moistened (wet) with salt solution or antibiotic ointment.
  
  
• Surgery: You 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 in the nose. Blood clots in the nose may be removed by making a small incision (cut) in your 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 you had a nasal trauma:

• Breathe through your mouth and lean forward to keep blood from going down the back of your throat.
  
  
• Ice may be applied on the swollen part to decrease swelling, pain, and redness.
  
  
• If your head is bleeding, apply direct pressure on the wound 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.

Where can I find more information? Contact the following for more information:

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

CARE AGREEMENT:

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

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