Wednesday, June 8, 2011

Nasal Bone Fracture - Nose Fracture

Overview, Causes, & Risk Factors

A nose fracture is a break in the nasal bone. Most of the nose is made of cartilage, a soft spongy material. The upper portion of the nose has a bone underneath it called the nasal bone.
What are the causes and risks of the injury?
Following are some of the possible causes of a nose fracture:
  • being flung into a hard object, such as in a motor vehicle accident

  • being hit on the side of the nose, such as in a fistfight

  • running into a hard object, such as another player's helmet during football

  • Symptoms & Signs

    What are the signs and symptoms of the injury?
    A fracture of the nose usually involves the following:
  • black eyes on both sides

  • deformed appearance of the nose

  • difficulty breathing through the clogged nostril

  • a feeling of pain along the bridge of the nose and the area between the eyes

  • nasal pain and swelling

  • nosebleed

  • Diagnosis & Tests

    How is the injury recognized?
    Diagnosis of a nose fracture begins with a medical history and physical exam. If the fracture is not obvious, X-rays may be taken to check for a nose fracture.

    Prevention & Expectations

    What can be done to prevent the injury?
    Sports safety guidelines should be followed by adults, adolescents, and children. Protective facewear should be worn while playing sports. Seat belts should be worn whenever a person is riding in a car. Avoiding trauma to the face helps to prevent nose fractures.

    Treatment & Monitoring

    What are the treatments for the injury?
    First aid for a suspected nose fracture includes the following steps:
    1. Keep the person calm.
    2. Have the person breathe slowly through the mouth and lean forward in a sitting position. This helps to prevent blood from going down the back of the throat, causing blockage. It also helps slow the blood flow.
    3. Apply cold compresses to the nose to help reduce swelling and also slow down bleeding.
    4. Consider pain medication, including acetaminophen or ibuprofen.
    5. Do not try to straighten a broken nose. Seek medical attention right away.
    Anyone with a suspected nose fracture should see a healthcare provider. The provider can pack the nose with gauze or cotton. He or she can also attempt to reset the bones. If the provider is not seen immediately, the nose will swell. The person must then wait about five days before the bones can be reset. Antibiotics may be given during or after this time to prevent infection.
    In most cases, local anesthesia is applied to the inside of the nose to numb it. Special probes are inserted into the nose to lift the broken bones back into place. After the bones are set, the gauze or cotton may need to be repacked.
    More complicated injuries may require a surgeon to cut into the skin at the front of the nose. Through this skin incision, the surgeon can piece the bones back together with special tools. Sometimes a person needs to wear a special device on the outside of the nose to help the nose heal properly. Plastic surgery may be required at a later time to fix any cosmetic problems.
    What are the side effects of the treatments?
    All surgery involves the risks of bleeding and infection. Antibiotics have side effects, such as stomach upset and allergic reactions.
    What happens after treatment for the injury?
    Unless the injury is severe, a person is able to go back to his or her normal routine almost immediately. Any new or worsening symptoms should be reported to the healthcare provider.


    Author:Adam Brochert, MD
    Date Written:
    Editor:Ballenberg, Sally, BS
    Edit Date:04/30/01
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:08/20/01

    Otolaryngology Head and Neck Surgery, 1998, Cummings et al.