Nasal Fracture

What is a nasal fracture?

Commonly called a broken nose, a nasal fracture is when the small bones near the top of the nose are broken. Nasal fractures are usually caused by accidental trauma to the nose such as impacts from falls or sports. The nasal bones are the most commonly broken bones in the human body.

How is a nasal fracture diagnosed?

Nasal fractures are diagnosed by a specialist such as an ear, nose and throat provider. Most of the time, fractures are diagnosed by simply looking at and feeling the nasal bones. X-rays are not usually necessary. However, most nasal fractures cannot be diagnosed immediately after the injury since swelling and pain usually make an examination of the nose difficult. It is best to wait about 5 days after the injury to allow the swelling and pain to subside before coming to see the specialist.

How is a nasal fracture treated?

Nasal fractures are usually treated using a technique called closed reduction. This means that the bones are moved back into their normal position without making any cuts in the skin. This is usually done with a combination of applying pressure to the outside of the nose with the fingers and inside the nose using an instrument inserted in the nostril (see illustration).

Since moving the bones in this way can be quite uncomfortable, this procedure it is performed in the operating room under general anesthesia. In this day and age, general anesthesia is very safe and your child will be carefully monitored during the procedure. You will have a chance to talk with the anesthesiologist on the day of surgery to discuss any questions you may have about the anesthesia.

Correction of nasal fractures should be done no later than 14 days after injury. If the procedure is delayed longer than this the bones may heal enough so they cannot be moved back into their normal position.

Although closed reduction is usually successful in restoring a normal nasal appearance this is not guaranteed in all children. Sometimes the bones have broken into too many pieces or won’t stay in the correct position after surgery. If this happens to your child, your doctor will explain what options you have to correct the problem.

Are there any instructions I need to follow before surgery?

Your child must have a physical examination by his or her pediatrician or family doctor within 30 days before surgery to make sure he or she is in good health. The doctor you see needs to complete the History and Physical form provided by our office. You must bring the completed form with you the day of surgery.

For your child's safety, it is very important that he or she have an empty stomach when anesthesia is given. Please follow Children’s Hospitals’ Eating and Drinking Guidelines. If you do not follow these guidelines, your child's surgery will be cancelled.

What can I expect after surgery?

The procedure itself usually takes no more than 15 or 20 minutes. Your child will wake up in the recovery room after surgery. This usually takes no more than 20 to 40 minutes. When your child is awake, he or she will be taken to the discharge area to complete the recovery. You can be with your child once he or she has been transferred to the discharge area.

• There may be a watery, mucus-like, or bloody discharge from either side of the nose for 2 or 3 days.
• Your child may have a small splint placed over the bridge of the nose. You should leave this in place until you see your doctor again (usually one week later). If the splint falls off, you can use some medical tape to secure it back into position.
• Your child may have a moderate increase in nasal pain after surgery. This is not usually as bad as the pain from the initial injury. You can treat this discomfort with Tylenol^® (acetaminophen) or Motrin^® (ibuprofen). If your child is having severe pain, your doctor may Fevers up to 102.0 F are considered normal after surgery. Call your provider for fevers over 102.0 F that do not come down with acetaminophen (Tylenol) and/or Ibuprofen prescribe a small amount of prescription pain medicine.
• Fevers up to 102.0 F are considered normal after surgery. Call your provider for fevers over 102.0 F that do not come down with acetaminophen (Tylenol) and/or Ibuprofen.
• You will get a Discharge Instructions sheet before you go home which will indicate how much medicine to give and how often.
• Your child should refrain from any contact sports or wrestling with siblings or friends for at least one week after surgery. Your doctor may recommend a more prolonged avoidance of these activities depending on the severity of the fracture.

Questions?

The information provided in this brochure is not specific to your child. This information is provided as a service to our patients. The information is for educational and informational purposes only and should NOT be used as a substitute for the advice of your child’s physician. If you have any questions, please call Children’s ENT and Facial Plastic Surgery Clinic.

Reviewed 10/2022

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