Information From Your Health Care Provider

NOSE FRACTURE

Basic information

description

A nose fracture is a break in the bones or cartilage of the nose. It often happens when other facial bones are also fractured. The injury may be to the front or the side of the nose. Males are more often affected than females.

FREQUENT SIGNS & SYMPTOMS

Pain in the nose.
Nosebleed.
Swollen, discolored nose.
Bruising around the eyes.
Difficulty in breathing through the nose.
Crooked or misshapen nose (sometimes).

causes

Injury or trauma to the nose. This is usually from a motor vehicle accident, being hit on the nose, running into a hard object, or from a fall.

risk increases with

Previous nose injury.

PREVENTIVE MEASURES

Wear protective headgear for contact sports or when riding motorcycles or bicycles.
Use seatbelts in motor vehicles.

expected outcomes

Minor fractures with no deformity usually heal on their own. Major fractures can be repaired with treatment. Most of the swelling will be gone in 10 to 20 days, but some swelling may last for months. The nose may feel tender for about a month.

possible complications

Infection of the nose and sinuses.
Persistent breathing difficulty.
Change in sense of smell.
Permanent change in appearance.
Deviated nasal septum. This occurs when the structure that divides the nose in half is off-center.
Septal hematoma. Blood becomes trapped in the septum. This can lead to complications if it is not drained.

diagnosis & treatment

general measures

First aid steps: Have the person sit down and lean forward to keep blood from going down the back of the throat. Have them breathe through the mouth. Apply cold compresses or an ice pack to the nose to reduce swelling. Do not try to move displaced bones in an attempt to straighten the nose. If a nosebleed is heavy or cannot be stopped, seek emergency medical care to get it under control.
Your health care provider will do a physical exam of the face and nose. X-rays may or may not be needed depending on the injury. A CT scan may be done.
A minor nose fracture with no displacement may not require further medical treatment. It will heal on its own. Rest at home. Apply ice several times a day until the swelling is gone. Use two pillows when lying down to keep the head above the heart. This helps with pain.
Treatment may involve reduction (correction) of the fracture. This can be done right after the injury, before any swelling occurs. It can also be done days later, when the swelling is gone. A local or general anesthetic is used.
The reduction may be done by manipulating the nose into place with finger pressure. It may require the use of two probes inserted into the nose to move the bones back into place. More severe fractures may require surgery. An incision (cut) is made on the front of the nose. The bones are put back together with special tools. Wires, plates, or screws may be used to hold the bones in place. A splint may be needed.
Plastic surgery can be done at a later date if there is a problem with the cosmetic appearance of the nose.

medications

For minor discomfort, you may use nonprescription drugs such as acetaminophen.
Stronger pain relievers may be prescribed.
Antibiotics may be prescribed to prevent or treat an infection.
Decongestants may be prescribed, to reduce swelling.

activity

Rest until any bleeding stops.
Most activities can be resumed right away.
You can usually return to non-contact sports in two weeks, and contact sports in three weeks. Protective gear may need to be worn. Follow any medical advice.