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3.10 Nasal Fracture


Presentation

After a direct blow to the nose the patient usually arives at the emergency department with minimal continued hemorrhage. There is usually tender ecchymotic swelling over the nasal bones or the anterior maxillary spine; inspection and palpation may (or may not) disclose a nasal deformity.

What to do:

What not to do:

Discussion

The two most common indications for reducing a nasal fracture are an unacceptable appearance and inability of the patient to breathe through the nose. Regardless of x-ray findings, if neither breathing nor cosmesis is a concern, it is not necessary to reduce the fracture. Nasal fractures are uncommon in young children, because their noses are mostly pliable cartilage. Suspect septal hematoma when a patient's nasal airway is completely occluded. Within 48 to 72 hours a hematoma can compromise the blood supply to the cartilage and cause irreversable damage.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
Mark Smith, MD
Jon Handler, MD
Michael Gillam, MD