Nose fracture Information | Mount Sinai

Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture 

A nose fracture is a break in the bone or cartilage over the bridge, or in the sidewall or septum (structure that divides the nostrils) of the nose.

A nasal fracture is a break in the bone over the ridge of the nose. It usually results from a blunt injury and is one of the most common facial fracture. Symptoms of a broken nose include pain, blood coming from the nose, bruising around the eyes, misshapen appearance, swelling, and difficulty breathing through the nose. Serious nose injuries can cause problems that require immediate attention. However, for minor nose injuries, the doctor may prefer to see the victim after the swelling subsides to evaluate the extent of injury.

Considerations

A fractured nose is the most common fracture of the face. It most often occurs after an injury and often occurs with other fractures of the face.

Nose injuries and neck injuries are often seen together. A blow that is forceful enough to injure the nose may be hard enough to injure the neck.

Serious nose injuries cause problems that need a health care provider’s attention right away. For example, damage to the cartilage can cause a collection of blood to form inside the nose. If this blood is not drained right away, it can cause an abscess or a permanent deformity that blocks the nose. It may lead to tissue death and cause the nose to collapse.

For minor nose injuries, the provider may want to see the person within the first week after the injury to see if the nose has moved out of its normal shape.

Sometimes, surgery may be needed to correct a nose or septum that has been bent out of shape by an injury. A doctor may be able to return nasal bones that have moved out of place back to their normal position within the first 2 weeks after the break.

Symptoms

Symptoms may include:

• Blood coming from the nose
• Bruising around the eyes
• Difficulty breathing through the nose
• Misshapen appearance (may not be apparent until the swelling goes down)
• Pain
• Swelling

The bruised appearance most often disappears after 2 weeks.

First Aid

If a nose injury happens:

• Try to stay calm.
• Breathe through your mouth and lean forward in a sitting position to keep blood from going down the back of your throat.
• Squeeze the nostrils closed and hold pressure to stop the bleeding.
• Apply cold compresses to your nose to reduce swelling. If possible, hold the compress so that there isn’t too much pressure on the nose.
• To help relieve pain, try acetaminophen (Tylenol).

Do Not

If a nose injury happens or if someone may have a broken nose:

• DO NOT try to straighten a broken nose.
• DO NOT move the person if there is reason to suspect a head or neck injury.

When to Contact a Medical Professional

Get medical help right away if:

• Bleeding does not stop
• Clear fluid keeps draining from the nose
• You suspect a blood clot in the septum
• You suspect a neck or head injury
• The nose looks deformed or out of its usual shape
• The person is having difficulty breathing

Prevention

Wear protective headgear while playing contact sports, or riding bicycles, skateboards, roller skates, or rollerblades.

Use seat belts and appropriate car seats when driving.

Chegar BE, Tatum SA. Nasal fractures. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 30.

Kim L, Huddle MG, Smith RM, Byrne P. Nasal fractures. In: Dorafshar AH, Rodriguez ED, Manson PN, eds. Facial Trauma Surgery. Philadelphia, PA: Elsevier; 2020:chap 1.10.

Mayersak RJ. Facial trauma. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 34.

Rodriguez ED, Dorafshar AH, Manson PN. Facial injuries. In: Rodriguez ED, Losee JE, Neligan PC, eds. Plastic Surgery: Volume 3: Craniofacial, Head and Neck Surgery and Pediatric Plastic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 3.

Last reviewed on: 11/29/2022

Reviewed by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Broken or Bruised Nose, No X-Ray

Based on your exam today, you have swelling and a bruise (contusion) in your nose. You likely have pain, swelling, and nasal stuffiness. You may also have bleeding from the nose. By tomorrow, you may have bruising around your eyes. A minor break (fracture) of the bone or cartilage may also have occurred. This generally isn’t serious. It’s treated the same way as a bruise. A nose bruise will heal in about 1 to 2 weeks. A minor break will heal in about 3 to 4 weeks.

If your nose looks crooked after the swelling goes down, then you likely have a break. A broken bone that changes the shape of the nose or causes trouble breathing may need to be treated by a surgeon. This might be an ear, nose, and throat doctor (ENT or otolaryngologist). Or it may be a plastic surgeon. They can straighten the bones in your nose. A nose break isn’t treated until the swelling goes down, so the surgeon can see is the nose is back in position. For a break with bones out of place, surgery to put the bones back into place (reduction) should be done 6 to 10 days after the injury. In children, it should be done 3 to 7 days after the injury. After that time, the bones get harder to move back into position.

Home care

• You can keep doing most daily activities. But be careful when doing them. Try not to lift anything heavy unless your healthcare provider says it’s OK.

• To ease pain and swelling, put a cold pack on your nose for 15 to 20 minutes at a time. Do this every 2 hours the first day. Then reduce to 3 to 4 times a day for the next 2 days. After that, use it as needed. To make a cold pack, put ice cubes in a bag that seals at the top. Wrap the bag in a thin towel. Don’t put it directly on your skin.

• Keep your head raised (elevated) to help reduce pain and swelling.

• Tell your healthcare provider if you’re taking aspirin or blood thinners (such as warfarin). These medicines make it more likely that your nose will bleed. Your dose may need to be changed.

• To control pain, use medicine as advised by your provider. You may be told to use over-the-counter ibuprofen or naproxen. If you have ulcers or bleeding problems talk with your provider before using these medicines.

• Don’t drink alcohol or hot liquids until your provider says it’s OK. These can open (dilate) blood vessels in your nose and cause bleeding.

• Don’t blow your nose for the first 2 days or until your provider says it’s OK. After that, do so gently to prevent bleeding.

• Don’t play contact sports for the next 6 weeks or until your provider says it’s OK to do so. 

Note about concussion

Because the injury was to your head, it’s possible that you could have a mild brain injury (concussion). Symptoms of concussion can show up later. For this reason, be alert for symptoms of a concussion. Get emergency medical care if any of these develop over the next hours or days:

• Headache

• Nausea or vomiting

• Dizziness

• Sensitivity to light or noise

• Abnormal sleepiness or grogginess

• Trouble falling asleep

• Personality changes

• Vision changes

• Memory loss

• Confusion

• Trouble walking or clumsiness

• Loss of consciousness (even for a short time)

• Inability to wake up

Follow-up care

Follow up with your healthcare provider as advised. If you were referred to a surgeon, make that appointment soon. Be sure to see a surgeon if your nose looks crooked after the swelling goes down. Or if it’s still hard to breathe through 1 or both sides of your nose. If you have trouble getting an appointment, call your regular provider.

When to get medical advice

Call your healthcare provider right away if any of these occur:

• Bleeding from your nose even after you’ve pinched your nostrils together for 15 minutes

• Swelling, pain, or redness on your face that gets worse

• Fever of 100.4ºF (38ºC) or higher, or as advised by your provider

• Chills

• Unable to breathe from both sides of the nose after swelling goes down

• Sinus pain

Call 911

Call 911 if any of these occur:

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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How to diagnose a nose fracture – advice from an otolaryngologist

How to diagnose a broken nose – advice from an otolaryngologist

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How to Diagnose a Nasal Fracture : A nose fracture is a complete or partial disruption of the integrity of the nasal bone under a load exceeding the strength of the injured skeletal area. Primary diagnosis of a nasal fracture will require an X-ray or CT scan of the nose and subsequent consultation with a traumatologist. As an additional examination, the doctor may prescribe an MRI of the nose.

Which doctor treats a broken nose : If you have symptoms of a broken nose, you should first consult an ENT doctor, based on the results of the initial examination, the doctor may prescribe an additional consultation with the surgeon.

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A nose fracture is a fracture of the bone, most often above the bridge of the nose. Common causes of a broken nose include contact sports, physical fights, falls, and car accidents. A broken nose can cause pain as well as swelling and bruising around the nose and under the eyes. Visually, the nose may look crooked, and breathing problems are possible. Surgery for a broken nose is usually not required.

Symptoms of a broken nose

Signs of a broken nose:

• pain, especially when touching the nose
• edema and adjacent areas
• nosebleed
• bruising around the nose or eyes
• curvature of the nose
• difficulty breathing through the nose
• mucus secretion
• congestion.

Which doctor diagnoses a broken nose

Seek emergency medical attention if a nose injury is accompanied by:

• an injury to the head or neck that may present with severe headache, neck pain, vomiting, or loss of consciousness
• shortness of breath
• bleeding that cannot be stopped
• noticeable change in the shape of the nose, not associated with edema, such as a crooked or deviated nose
• nasal discharge of clear watery liquid.

If you have a deviated nose, make an appointment with an ENT doctor.

Diagnosis of the cause of a broken nose

Common causes of a broken nose include:

• Injuries from contact sports such as football or hockey
• physical impact
• car accidents
• fall

A broken nose can even be caused by hitting an immovable object such as a door or wall, or by rough play resembling wrestling.

Risk factors

Any activity that increases the risk of facial injury increases the risk of a nose fracture. These activities include:

• playing contact sports such as football and hockey, especially without a helmet with a face mask
• participating in a fight
• cycling
• lifting weights, especially without the support of an observer
• riding in a car, especially without a seat belt.

Diagnosis of complications

Complications associated with a broken nose may include:

deviated septum. A condition that occurs when the thin wall separating the two sides of the nose shifts, narrowing the nasal passage. Medications such as decongestants and antihistamines can help manage a deviated septum. But to correct this condition, an operation is required

accumulation of blood. Sometimes, there is a collection of clotted blood in a broken nose, leading to a condition called a septal hematoma that blocks off one or both nostrils. Septal hematoma requires prompt surgical drainage to prevent cartilage damage

cartilage fracture. If the fracture occurs as a result of a strong impact, such as a car accident, cartilage fracture can also occur. If the injury is severe enough to require surgery, the surgeon must repair both bone and cartilage damage.

Nasal Fracture Diagnosis

The ENT doctor will gently press on the outside of the nose and surrounding areas and look into the nasal passage. If necessary, he will use anesthetics – nasal sprays or local injection. Nose x-ray and other imaging studies are usually not required. However, a doctor may recommend a CT scan of the nose if the severity of the injury precludes a thorough physical examination.

Author: Viktor Evgenievich Tolnikov

Specialization: Orthopedist, Traumatologist, Sports doctor Vreden

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Literature

1. Algorithm for choosing the method of nose reconstruction / S. L. Vasiliev, I. A. Karpov, M. A. Kuchenkova et al. // Russian Rhinology. – 2005. – No. 3. – S. 3942.
2. Aref’eva, N. A. Immunological aspects of rhinitis classification / N. A. Aref’eva // Russian rhinology. – 1997. – No. 2.- S. 7-8.
3. Boymuradov, Sh. A. The incidence of fractures of the bones of the nose among facial injuries / Sh. A. Boymuradov // Russian otorhinolaryngology. -2006. – No. 4. – S. 4-6.
4. Possibilities of virtual rhinometry in case of damage to the external nose / M. A. Popov, Yu. Yu. Rusetsky, N. I. Kovalevskaya et al. // Bulletin of Otorhinolaryngology. – 2007. – No. 5. – App. – S. 184-185.
5. Eremina, NV Diagnosis and treatment of nasal fractures using ultrasonography / NV Eremina, IO Chernyshenko, Yu. Yu. Rusetskiy // Russian Otorhinolaryngology. – 2007. – No. 4. – S. 73-79.

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Fracture of the nose with and without displacement – signs, treatment, surgery – clinic “Dobrobut”

Main

Medical Library Dobrobut

Publication date: 2020-05-12

Fracture of the nose in children, adults – signs and treatment

Fracture of the nose in children and adults is an injury that is diagnosed in 40% of cases of total facial injuries. Most often, this is the result of direct trauma – for example, when striking the bridge of the nose or another part of the nose. The result is damage to the bone (back of the nose) or cartilage (the front, “wings”).

Signs of a nose fracture depending on the type of injury

In medicine, there are several types of damage under consideration:

1. Closed fracture of the nose without displacement. Of the visible signs, only an extensive bruise and swelling of the upper part of the face stand out. There is no change in the shape and location of the nose. Visual depression of the nose may be present, but the exact location of the fracture can only be determined by palpation. An X-ray is required to confirm the diagnosis. If the injury is severe, then damage to the nasal mucosa and, as a result, bleeding is possible.
2. Open fracture without displacement. The signs are the same as in the previous case, but the point of injury is determined visually – the skin is damaged, protruding bone fragments are clearly visible.
3. Displaced fracture of the nose. A complex injury that can lead to respiratory failure, purulent tissue damage, problems with water and electrolyte balance, trigeminal neuritis. You will definitely need to use the work of a plastic surgeon to perform rhinoplasty and restore your appearance.

General signs of a broken nose:

• hematomas around the eyes, on the bridge of the nose, may extend to the forehead;
• swelling of the upper and central part of the face;
• acute pain at the site of injury, aggravated by palpation;
• difficult to stop bleeding from the nasal passages;
• problems with nasal breathing.

If a comminuted fracture occurs, crepitus may be present – crunching when touched, abnormal mobility (the nose can literally be put on its side).

The severity of a nose fracture is determined only after the patient has been examined by a doctor. For example, with a slow spread of hematomas and a gradual increase in edema, which are accompanied by increasing headaches, there is a risk of not only the injury in question, but also a fracture of the bones of the base of the skull. And in this case, immediate hospitalization and an extensive examination of the patient, including computed tomography, are required.

Treatment of a broken nose

Even if it seems that there is no nose fracture, but a normal bruise has occurred, you need to seek help from a doctor – with the help of x-rays and palpation, he will make an accurate diagnosis. If there is no displacement of bone fragments, then the nose after the fracture does not require surgical intervention, therapy is prescribed:

• nasal drops with vasoconstrictive properties;
• painkillers – Ketanov, Deksalgin;
• quick bruising ointments – Rescuer, any with troxevasin.

If a displaced fracture is diagnosed, surgical intervention is prescribed – bone reposition, which allows restoring the correct relief. This manipulation is performed under local anesthesia.

If there was a complex fracture of the nose, and the operation was not performed at the designated time, then you will have to resort to rhinoplasty or septoplasty (correction of the nasal septum) in the future. But first, classical surgical treatment should be carried out, then antibiotic therapy. It is necessary to wait for a full recovery, which may take about six months.

The injuries in question are not uncommon for children, so it is worth knowing the rules of first aid for a child. You can learn about them at a consultation with a doctor, and make an appointment through our website dobrobut.com

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