A nasal fracture or a broken nose is any crack or fracture in the bony portion of your nose.
It is the most common fracture of the face and occurs as a result of a blunt injury to the face. Common causes of a nose injury include falls, physical fights, contact sports, and vehicle accidents.
Nasal fractures account for approximately 40 percent of facial bone injuries. Serious nose injuries usually need immediate attention as they can lead to the pooling of blood in the nose that needs to be drained right away, or it may lead to complications.
Let’s take a look at the causes, symptoms, risk factors, and ways to manage nasal fractures.
What are the common causes of nasal fractures?
The most common cause of a nasal fracture is a serious blunt injury to your face. This can happen:
While playing any of the contact sports such as rugby, wrestling, soccer, American football, hockey, or basketball.
During motor vehicle accidents.
During falls and physical fights (getting punched on the nose).
While accidentally walking into a wall.
What are the symptoms of nasal fractures?
Common symptoms of nasal fractures include:
Bleeding from the nose
Pain or tenderness while touching the nose
Swelling of the nose and the surrounding area
Difficulty in breathing through the nose
Bruising (discoloration of the skin) of the nose or under the eyes
Deformity of the nose (crooked nose)
Persistent drainage from one or both the nostrils (two openings on either side of your nose)
A change in or loss of sense of smell
A crackling or grating sound while moving the nose
A feeling of nasal passages being blocked
What are the risk factors of nasal fractures?
Any activity that increases the risk of a facial injury can be a risk factor for nasal fractures. This includes playing various contact sports, riding a bicycle, getting into physical fights, riding motor vehicles without a seatbelt and helmet, and doing other activities such as skiing or skating, without wearing protective headgear.
Regardless of these activities, the elderly (individuals older than 60 years of age) are at a higher risk of nasal fractures as they are prone to frequent falls due to their deteriorating health.
The toddler age group (children aged 0-3 years) is also at a higher risk as their bone mass (density of the bone), being in the development stage is low and any impact to their face could cause a nasal fracture.
What are the complications of nasal fractures?
Possible complications of a broken nose include:
Collection of blood. Following a nasal fracture, blood pools inside the nose and forms blood clots. This condition is called a septal hematoma and can block one or both of the nostrils.In such conditions, the blood needs to be drained immediately to prevent damage to the cartilage (a flexible fibrous tissue seen in the nose and many other parts of the body).
Breathing difficulty. You might have nasal stuffiness (congestion of the nose), resulting in difficulty in breathing due to the fracture.
Infections. You may have an infection in the nose, sinuses (4 air-filled sacs present in your facial bones), or in the facial bones.This infection can turn severe if it reaches your brain causing a brain abscess (infection in the brain), meningitis [inflammation of the meninges (three-layered membrane that covers the brain and the spinal cord)] or cerebrospinal fluid (CSF) infection (clear watery fluid that surrounds your brain and spinal cord that acts as a cushion against any injury to the brain).
A deviated septum (crooked nose). Your nasal septum is the thin cartilage that separates the right and left nostrils. A nasal fracture can lead to a deviated septum (displacement of the septum from its normal position), resulting in the narrowing of the nasal passage. A deviated septum is usually treated with surgery.
A hole in the septum. Nasal fractures can lead to the formation of a hole in the septum, causing the bridge of the nose to collapse (saddle nose deformity). This condition will have to be corrected surgically.
How is a nasal fracture diagnosed?
To diagnose a nasal fracture, your doctor will do a physical examination and record your medical history in detail. Your doctor will examine your nasal passages during the physical examination to check for any blockages or further signs of broken bones.
Your doctor may prescribe certain imaging tests such as X-rays or CT (computerized tomography) scans to confirm the diagnosis and assess the severity.
How are nasal fractures treated?
Depending on the intensity of your injury, you may take first aid at home and meet the doctor later or you might require immediate medical attention.
First Aid at Home: If you have serious symptoms that warrant immediate medical attention, here are a few things that you can do at home before meeting the doctor.
Sit down comfortably, lean forward, and breathe through your mouth, in case your nose is bleeding. By doing this, you can prevent the blood from draining into the back of your throat, which can cause further complications.
Elevate your head to reduce the throbbing pain, in case it is severe. Elevating your head can reduce the pressure in your head, open up your airways and help you breathe better.
Apply cold compress or ice wrapped in a cloth onto your nose for 10-15 minutes to minimize further irritation and reduce inflammation (your body’s response to injuries resulting in redness and swelling).
Take over-the-counter (OTC) painkillers to reduce the pain.
Medical Treatments: Depending on the severity of your injury, your doctor will provide the appropriate treatment. It may include the following:
Pack your nose with gauze and place a splint (a flexible medical device that prevents any further displacement of an injured body part) on your nose to prevent complications.
Perform a rhinoplasty, which is a surgical procedure to realign your nose.
Perform a closed reduction surgery where your nose is manually realigned.
Perform a septorhinoplasty, which is a surgical procedure to replace your nasal septum.
Surgical procedures such as rhinoplasty, closed reduction, and septorhinoplasty are performed only after 3-10 days from the time of injury, once the swelling subsides.
Surgical treatment is usually not necessary for minor injuries where there is no misalignment and can be managed medically. However, moderate to severe injuries will require surgical correction.
How to prevent nasal fractures?
Taking the following simple precautions can help you prevent nasal fractures:
Wear protective gear that can prevent injuries to your face while playing contact sports.
Wear a helmet that provides proper coverage to your face while driving or during other activities such as skating or skiing.
Put on your seat belt while driving or traveling in a motor vehicle.
Use footwear with proper traction (a shoe sole that provides resistance against sliding) so that it helps prevent falls.
When is a nasal fracture an emergency?
A nasal fracture or a broken nose can be considered as an emergency in the following situations:
When there is severe or persistent bleeding
If you experience difficulty in breathing
When there is a large open wound on the face
If any debris is stuck inside the nose, such as broken glass
You will need immediate medical attention in case you show signs of a head injury such as:
Severe headache
Blurred vision
Confusion or memory loss
Loss of consciousness
Difficulty in moving and talking
A clear, watery liquid draining from the nose
Seizures (violent shaking that occurs due to uncontrolled electrical activity in the brain)
Nasal fractures are not always serious, minor cases can be easily managed with simple measures. If a severe break has occurred, then you will need a surgical correction. In most cases, your nose heals without any complications.
References:
1.Mount Sinai Health System. 2021. Nose fracture Information | Mount Sinai - New York. [online] Available at: <https://www.mountsinai.org/health-library/injury/nose-fracture> [Accessed 14 April 2021].
2. Uofmhealth.org. 2021. Broken Nose (Nasal Fracture) | Michigan Medicine. [online] Available at: <https://www.uofmhealth.org/health-library/aa49289spec> [Accessed 14 April 2021].
3.Kucik, C., Clenney, T. and Phelan, J., 2021. Management of Acute Nasal Fractures. [online] Aafp.org. Available at: <https://www.aafp.org/afp/2004/1001/p1315.html> [Accessed 14 April 2021].
Disclaimer: This article is written by Practo for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.