Nasal bone fracture

A.Prof Frank Gaillard and Radswiki et al.

Nasal bone fractures are the most common type of facial fractures, accounting for ~45% of facial fractures, and are often missed when significant facial swelling is present. 

Unsurprisingly, nasal bone fractures occur when the nose impacts against a solid object (e.g. fist, forehead, dashboard, etc). Lateral impact injuries are the most common type of nasal injury leading to fracture.

Nasal bone fractures when isolated are most commonly a displaced fracture of one the paired nasal bones. There is often association with other facial fractures and this requires careful assessment 3,5:

Nasal septal haematoma should also be actively assessed for. 

It should be noted that cartilaginous injuries cannot be detected radiologically and that imaging of simple nasal bone fractures often add little to patient management. However, imaging can be useful in documentation, assessing extent and associated facial fractures and/or complications 5.

  • sensitivity ~80% 6
  • best detected on lateral view
  • Waters view is useful in assessing the nasal arch 4
  • sensitivity is 100% 6

Treatment depends on the degree of displacement. If alignment is essentially anatomical then no treatment is required. If displacement is significant then if untreated they may result both in unfavourable cosmetic result and in impaired function (i.e. difficulty in breathing through one or both nasal passages). Untreated nasal fractures account for a high percentage of rhinoplasty and septoplasty procedures. 

The worst morbidity results from septal haematoma, leading to nasal septal perforation and necrosis, which causes severe nasal collapse and deformation.

  • longitudinally-orientated fractures may be confused for the nasomaxillary suture and/or nasociliary groove
Fractures
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Article information

rID: 12964
Synonyms or Alternate Spellings:
  • Nasal bone fractures
  • Nasal bony fractures
  • Nasal bony fracture
  • Fracture of nasal bone
  • Nasal fracture
  • Nasal fractures

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    Case 2: on MRI
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    Profile view, nas...
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    Slightly dislocat...
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