Introduction
A nasal fracture is the most common fracture of the face. There is a break in the bone or cartilage of the nose, either the bones that form the bridge of the nose or the sidewall or the septum of the nose (the structure that divides the nostril into two). The common causes of this are contact sports, motor vehicle accidents, physical fights, and falls, which will result in trauma to the face.
Nose injuries are commonly tagged along with neck injuries. A trauma that can cause nose injury will also result in neck injury. Nasal injuries can sometimes be life-threatening, as in the case of a fracture to the cartilage of the nose, which results in a pooling of blood in the nose. In this case, if drainage is not attained early, it can lead to abscess formation or permanent deformity, which can block the nose and can be a serious complication. When the nasal fracture causes a deformed nose, the surgical correction can be done within the first two weeks of the injury.
What Are the Causes and Risk Factors for a Nasal Fracture?
The common causes of nasal fracture are:
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Trauma from contact sports such as boxing, football, and hockey.
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Physical fight.
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When the face hits the floor or other surfaces after a fall.
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Motor vehicle accidents.
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In trauma involving the mouth or teeth, one should suspect a nasal fracture.
The risk factors of nasal fracture are:
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Weight lifting.
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Riding motor vehicles without seat belts.
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Getting involved in physical fights.
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Playing football or hockey.
What Are the Symptoms of a Nasal Fracture?
The symptoms of the nasal fracture include the following:
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Bleeding from the nose (epistaxis).
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Pain or tenderness.
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Displaced bone or cartilage of the nose.
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Change in shape of the nose.
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A dip in the nasal bridge.
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Bruising around the eyes and the nose.
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Swelling is seen on the nose and the surrounding areas.
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Difficulty in breathing.
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Discharge of mucus from the nose.
How to Diagnose Nasal Fracture?
The doctor makes the diagnosis by doing a physical examination. The doctor will gently palpate the nose and look for any fractures. Also, look inside the nose for any blockage inside or visible fracture. As the patient may have pain, the doctor will use local anesthetics in the form of sprays to palpate the patient. The doctor may also advise an X-ray or CT (computed tomography) scan to get a clear picture of the involvement and extent of the fracture, as other facial bone fractures can also be suspected. Also, in case of severe injury, the radiography method will aid in diagnosis, as doing a physical examination might not be feasible.
What Are the Treatment Options for Nasal Fractures?
If the fracture is minor and does not cause any disfigurement to the structure of the nose, then the doctor would advise some medications for the pain and other self-care methods like applying ice over the site of injury.
When a nose injury happens, the following first aid should be done:
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Calm the patient.
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The patient should be seated in an upright position so that the blood is not aspirated.
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Ask the patient to breathe through the nose.
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Hold the nostrils closed and apply pressure to stop the bleeding.
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Apply cold compression for the swelling around the nose.
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Take over-the-counter painkillers like Acetaminophen.
The doctor might realign the fracture segment manually or surgically. If there is a fracture in the nasal bones, the doctor will manually fixate them if one consults the doctor within the first two weeks of the injury. To do manual realignment, the doctor would give anesthetics to that area either in the form of spray or injections. Special instruments are used to fix the fracture without any openings made in the skin. Following this, a nasal pack is given, and maybe a dressing is also given from outside. This pack is placed for at least one week. Also, the doctor will prescribe antibiotics to prevent any infections.
In other cases, the fracture needs to be fixed surgically, such as in severe fractures, multiple fractures, or fractures left untreated for more than 14 days. If there is a fracture to the nasal septum that causes obstruction or difficulty in breathing, then reconstructive surgery might be done.
When to See a Doctor?
Medical attention should be given right away when one notices any of these things, such as:
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When one suspects head or neck injury along with nasal injury.
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Nasal bleeds, which does not stop.
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Clear fluid drainage from the nose.
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Vomiting or a patient being unconscious following a trauma.
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When one suspects a blood clot in the nasal septum.
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When there is difficulty in breathing through the nose.
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When there is a noticeable deformity to the shape of the nose.
What Are the Complications of Nasal Fracture?
The complications related to the nasal fracture are:
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Deviated Nasal Septum - Upon injury to the nasal septum, the nasal septum, which divides the nostril into two sections, may deviate from the midline to any side, causing the narrowing of the nasal passage, which will interfere with breathing. Nasal decongestants and antihistamines can be given for temporary relief from the symptoms, but surgery can only be the solution for this condition.
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Pooling of Blood - Sometimes, following a nasal trauma, the pooling of blood happens in the nasal septum, also known as a septal hematoma (clotted blood pool). This hematoma can block one or both nostrils. Pooling of blood is a serious complication and requires immediate surgical drainage.
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Neck Injury - The bones of the neck also get fractured or damaged in some cases due to the strong blow from any kind of trauma or accident. Thus, if a neck injury is suspected, one should immediately consult the doctor.
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Cartilage Fracture - The forceful blow to the cartilage from automobile accidents often leads to cartilage fractures. Therefore, if surgical intervention is needed in such a case, the doctor would address both neck and nasal fractures.
Conclusion
A nasal fracture is a break in the bone or cartilage of the nose that can occur while playing a contact sport, falling, in physical fights, or in motor vehicle accidents. A minor fracture requires only self-care and over-the-counter painkillers, but in a severe fracture, surgical intervention will be required. If one suspects any injury to the nose following an accident, consult a doctor as early as possible because, with early intervention, minimal treatment will be required. Minor fractures can be aligned manually by a doctor only if the patient reports to the doctor within the first 14 days of the injury. Therefore, to prevent such injuries, one should always keep in mind the need to use safety equipment, such as helmets and seat belts, while playing a contact sport or driving a vehicle.
