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Nasal Fracture


What is a nasal fracture?

A nasal fracture (broken nose) is a crack or break in the bones or cartilage of your nose. Cartilage is tough tissue that covers the end of a bone. You may have a break in the upper nose (bridge), the side, or in the septum. The septum is in the middle of the nose and divides your nostrils.

What causes a nasal fracture?

Nasal fractures are caused by a hard hit to the nose. They commonly occur from motor vehicle crashes, sports injuries, falls, and fights.

What are the signs and symptoms of a nasal fracture?

  • Deformed nose: Your nose may look like it has moved out of place. It may bend toward 1 side of your face or look wider than usual. You may hear a scraping sound when your nose moves.
  • Bloody nose: A bloody nose is a common sign of a nasal fracture. You may see only small amounts of blood, or you may bleed heavily. The amount of blood will depend on how badly your nose was broken.
  • Bruises and swelling: Your nose will begin to swell within 1 to 2 hours of your injury. You may have black eyes because of bruising under your eyes.

How is a nasal fracture diagnosed?

Your caregiver will ask you when, where, and how the injury occurred. He may ask if you were drinking alcohol before the injury. Tell your caregiver about any past surgeries, illnesses, or injuries. Caregivers may take photos of your face. They may also ask for a photo of you taken before your injury.

  • Nasal exam: You will be given pain medicine before your caregiver touches and looks at the outside and inside of your nose. He will use tools to remove blood clots and check for large hematomas (collections of blood).
  • X-rays: X-rays may be done to help find any other injuries to your face and head.
  • A CT , or CAT scan, takes pictures of your skull and brain. You may be given contrast liquid before the scan. Tell a healthcare provider if you have ever had an allergic reaction to contrast liquid.

How is a nasal fracture treated?

Caregivers may use any of the following to treat your nasal fracture:

  • Medicines:
    • Pain medicine: You will be given medicine to take away or decrease pain. Do not wait until the pain is severe before you take this medicine.
    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    • Decongestant: This medicine decreases nasal swelling and helps make breathing easier.
  • Wound care: Caregivers will use medicines, tools, or gauze inside your nose to stop the bleeding. Wounds on your face will also be cleaned and treated. Any hematomas you have inside your nose will be drained. Caregivers may place packing (gauze or other material) inside your nostrils to soak up blood.
  • Reduction: Some nasal fractures must be moved back into place (reduction). Caregivers may perform reduction right away if your injury is new. You might be asked to return for treatment within 2 to 10 days if your nose has swollen. Caregivers numb your nose to reduce pain before the reduction. The medicine is given with a shot, through pads placed on your skin, or through an IV. Caregivers may use tools that move your nose without incisions (cuts) in your skin. This is called closed reduction. Your nasal fracture may instead be repaired through incisions. This is called open reduction.
  • Splints or packing: Splints or packing help keep your nose in place for 7 to 10 days after a reduction. Ask your caregiver to show you how to care for your splint or packing.

What are the risks of a nasal fracture?

  • You may have an allergic reaction to the medicines used to treat your nasal fracture. Even after a closed or open reduction, your nose may be misshapen. You may need more than 1 surgery.
  • Without prompt treatment, your nose may not look as it did before your injury. You may have other fractures to your face and head that can worsen without care. Poor healing may lead to long-term problems with sinus infections or nose breathing. You may need surgery to correct these problems. Fractures in the face and head can cause cerebrospinal fluid (CSF) from your brain to leak out of from your nose. Infections can occur even with treatment. Any hematomas that form can become serious infections. These infections may be life-threatening if they spread deeper into your skull or brain.

How do I care for my nasal fracture at home?

  • Rest: Rest when you feel it is needed. Slowly start to do more each day. Return to your daily activities as directed.
  • Ice: Place an ice pack over your nose to help reduce pain and swelling. Ask your caregiver how long and how often to use the ice pack.
  • Rinses: Remove blood and crusting inside your nose with water or saline ( salt water). Ask your caregiver to show you how to rinse your nose.

When should I follow up with my caregiver?

You may need to see a specialist 2 to 5 days later for more treatment. Sometimes follow-up care is needed months or even years later to correct problems. Ask your caregiver when you should see a specialist.

How do I prevent further injury to my nose?

  • Protect your nose: Protect your nose to prevent bleeding, bruising, or another fracture. If you play sports, ask your caregiver if you can wear a face mask to shield your nose.
  • Do not blow your nose: Your nose could move out of place before it heals. Ask your caregiver when you can safely blow your nose again.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.
  • You keep having nosebleeds.
  • Your headache is getting worse, even with pain medicine.
  • Your skin feels itchy, swollen, or has a rash.
  • Your splints or packing are loose.
  • You have questions about your condition or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • Someone has harmed you.
  • Clear fluid is leaking from your nose.
  • You have double vision or have problems moving your eyes.
  • You are having problems breathing, smelling, or talking.
  • You have a grape-like swelling inside your nose.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.