Nasal bone fracture
Citation, DOI, disclosures and article data
At the time the article was created The Radswiki had no recorded disclosures.
View The Radswiki's current disclosuresAt the time the article was last revised Tariq Walizai had no financial relationships to ineligible companies to disclose.
View Tariq Walizai's current disclosures- Nasal bone fractures
- Nasal bony fractures
- Nasal bony fracture
- Fracture of nasal bone
- Nasal fracture
- Nasal fractures
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.
On this page:
Clinical presentation
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.
Intimate partner violence should be considered in patients where the clinical details do not match the fracture, or the injury occurs in an intimate setting 7.
Pathology
Nasal bone fractures, when isolated, are most commonly displaced fractures of one of the paired nasal bones. There is often associated with other facial fractures and this requires careful assessment 3,5:
frontal process of the maxilla
Nasal septal hematoma should also be actively assessed.
Radiographic features
It should be noted that cartilaginous injuries cannot be detected radiologically and that imaging of simple nasal bone fractures often adds little to patient management. However, imaging can be useful in the documentation, assessing the extent and associated facial fractures and/or complications 5.
Plain radiograph
sensitivity ~80% 6
best detected on the lateral view
Waters view is useful in assessing the nasal arch 4
CT
sensitivity is 100% 6
Treatment and prognosis
Treatment depends on the degree of displacement. If the alignment is essentially anatomical then no treatment is required. If the displacement is significant then if untreated they may result both in an unfavorable 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 hematoma, leading to nasal septal perforation and necrosis, which causes severe nasal collapse and deformation.
Differential diagnosis
longitudinally-oriented fractures may be confused for the nasomaxillary suture and/or nasociliary groove
nasal bone foramen 8
References
- 1. Han DS, Han YS, Park JH. A new approach to the treatment of nasal bone fracture: radiologic classification of nasal bone fractures and its clinical application. J. Oral Maxillofac. Surg. 2011;69 (11): 2841-7. doi:10.1016/j.joms.2011.01.013 - Pubmed citation
- 2. Atighechi S, Karimi G. Serial nasal bone reduction: a new approach to the management of nasal bone fracture. J Craniofac Surg. 2009;20 (1): 49-52. doi:10.1097/SCS.0b013e318190def5 - Pubmed citation
- 3. Kucik CJ, Clenney T, Phelan J. Management of acute nasal fractures. Am Fam Physician. 2004;70 (7): 1315-20. Pubmed citation
- 4. Dolan K, Jacoby C, Smoker W. RadioGraphics. 1984;4 (4): . doi:10.1148/radiographics.4.4.577
- 5. Brant WE, Helms C. Fundamentals of Diagnostic Radiology. Lippincott Williams & Wilkins. (2012) ISBN:1608319113. Read it at Google Books - Find it at Amazon
- 6. Baek HJ, Kim DW, Ryu JH et-al. Identification of Nasal Bone Fractures on Conventional Radiography and Facial CT: Comparison of the Diagnostic Accuracy in Different Imaging Modalities and Analysis of Interobserver Reliability. Iran J Radiol. 2013;10 (3): 140-7. Free text at pubmed - Pubmed citation
- 7. Alessandrino Francesco, Abhishek Keraliya and Jordan Lebovic et al. "Intimate Partner Violence: A Primer for Radiologists to Make the “Invisible” Visible". RadioGraphics 40, no. 7 (2020): 2080-2097. . doi:10.1148/rg.2020200010.
- 8. Zhang Lin, Wang Yeda, Li Baojiu, He Anwei, He Zhen, Fu Fei, Sun Donghui, Liu Jingyan, Qi Yang, & Qi Ji (2008). The differentiation of the nasal bone foramens and the fractures of nasal bone with high-resolution CT. Chinese Journal of Radiology, 42(4), 359-362.
Incoming Links
- Anterior nasal spine fracture
- Gorlin-Goltz syndrome
- Nasal bone fracture
- Ocular globe rupture and orbital blow-out fracture
- Orbital blow-out and nasal bone fractures
- Nasal bone fracture
- Nasal wall fracture
- Nasal bones fracture-dislocation and distended lacrimal sacs
- Nasal bone fracture
- Nasal bone fracture
- Odontoid fracture type II and Jefferson fracture
- Incidentally discovered metastatic renal cell carcinoma
- Nasal bone fracture
- Nasal bone fracture
- Nasal bone fracture
- Nasal bone fracture
- Nasal bone fracture
- Nasal bone fracture
- Nasal bone fracture
- Nasal bone fracture
Related articles: Fractures
-
fracture
- terminology
- fracture location
- diaphyseal fracture
- metaphyseal fracture
- physeal fracture
- epiphyseal fracture
- fracture types
- avulsion fracture
- articular surface injuries
- complete fracture
- incomplete fracture
- infraction
- compound fracture
- pathological fracture
- stress fracture
- fracture displacement
- fracture location
- fracture healing
- skull fractures
-
facial fractures
- fractures involving a single facial buttress
- alveolar process fractures
- frontal sinus fracture
- isolated zygomatic arch fractures
- mandibular fracture
- nasal bone fracture
- orbital blow-out fracture
- paranasal sinus fractures
- complex fractures
- dental fractures
- fractures involving a single facial buttress
-
spinal fractures
- classification (AO Spine classification systems)
-
cervical spine fracture classification systems
- AO classification of upper cervical injuries
- AO classification of subaxial injuries
- Anderson and D'Alonzo classification (odontoid fracture)
- Roy-Camille classification (odontoid process fracture)
- Gehweiler classifcation (atlas fractures)
- Levine and Edwards classification (hangman fracture)
- Allen and Ferguson classification (subaxial spine injuries)
- subaxial cervical spine injury classification (SLIC)
- thoracolumbar spinal fracture classification systems
- three column concept of spinal fractures (Denis classification)
- classification of sacral fractures
-
cervical spine fracture classification systems
- spinal fractures by region
- spinal fracture types
- classification (AO Spine classification systems)
- rib fractures
- sternal fractures
-
upper limb fractures
- classification
- Rockwood classification (acromioclavicular joint injury)
- AO classification (clavicle fracture)
- Neer classification (clavicle fracture)
- Neer classification (proximal humeral fracture)
- AO classification (proximal humeral fracture)
- AO/OTA classification of distal humeral fractures
- Milch classification (lateral humeral condyle fracture)
- Weiss classification (lateral humeral condyle fracture)
- Bado classification of Monteggia fracture-dislocations (radius-ulna)
- Mason classification (radial head fracture)
- Frykman classification (distal radial fracture)
- Mayo classification (scaphoid fracture)
- Hintermann classification (gamekeeper's thumb)
- Eaton classification (volar plate avulsion injury)
- Keifhaber-Stern classification (volar plate avulsion injury)
- upper limb fractures by region
- shoulder
- clavicular fracture
-
scapular fracture
- acromion fracture
- coracoid process fracture
- glenoid fracture
- humeral head fracture
- proximal humeral fracture
- humeral neck fracture
- arm
- elbow
- forearm
- wrist
-
carpal bones
- scaphoid fracture
- lunate fracture
- capitate fracture
- triquetral fracture
- pisiform fracture
- hamate fracture
- trapezoid fracture
- trapezium fracture
- hand
- shoulder
- classification
- lower limb fractures
- classification by region
- pelvic fractures
- hip fractures
- Pipkin classification (femoral head fracture)
- Garden classification (hip fracture)
- American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture)
- Cooke and Newman classification (periprosthetic hip fracture)
- Johansson classification (periprosthetic hip fracture)
- Vancouver classification (periprosthetic hip fracture)
- femoral
- knee
- Schatzker classification (tibial plateau fracture)
- AO classification of distal femur fractures
- Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture)
- tibia/fibula
- Watson-Jones classification (tibial tuberosity avulsion fracture)
- ankle
- foot
- Berndt and Harty classification (osteochondral lesions of the talus)
- Sanders CT classification (calcaneal fracture)
- Hawkins classification (talar neck fracture)
- Myerson classification (Lisfranc injury)
- Nunley-Vertullo classification (Lisfranc injury)
- pelvis and lower limb fractures by region
- pelvic fracture
- sacral fracture
- coccygeal fracture
-
hip
- acetabular fracture
- femoral head fracture
-
femoral neck fracture
- subcapital fracture
- transcervical fracture
- basicervical fracture
-
trochanteric fracture
- pertrochanteric fracture
- intertrochanteric fracture
- subtrochanteric fracture
- femur
- mid-shaft fracture
- bisphosphonate-related fracture
- distal femoral fracture
- knee
- avulsion fractures
- Segond fracture
- reverse Segond fracture
- anterior cruciate ligament avulsion fracture
- posterior cruciate ligament avulsion fracture
- arcuate complex avulsion fracture (arcuate sign)
- biceps femoris avulsion fracture
- iliotibial band avulsion fracture
- semimembranosus tendon avulsion fracture
- Stieda fracture (MCL avulsion fracture)
- patellar fracture
- tibial plateau fracture
- avulsion fractures
- leg
- tibial tuberosity avulsion fracture
- tibial shaft fracture
- fibular shaft fracture
- Maisonneuve fracture
- ankle
- foot
- tarsal bones
- metatarsal bones
- phalanges
- classification by region
- terminology
Unable to process the form. Check for errors and try again.