Broken Nose (Nasal Fracture)

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Topic Overview

How do I get a broken nose?

You can break your nose during play, sports, accidents, fights, and falls. But it may be hard to tell if your nose is broken. Swelling can make your nose look crooked even if it is not broken. When the swelling goes down after a few days, it is easier to tell if your nose is really crooked and possibly broken.

What are the symptoms?

Symptoms of a broken nose include:

• Nose pain.
• Swelling of the nose.
• A crooked or bent appearance.
• Bruising around the nose or eyes.
• A runny nose or a nosebleed.
• A grating sound or feeling when the nose is touched or rubbed.
• Blocked nasal passages.

Possible complications of a broken nose include:

• Change in the appearance of the nose or the tip of the nose.
• A large amount of blood in the nasal septum (nasal septal hematoma).
• A hole in the nasal septum (septal perforation) or causing the bridge of the nose to collapse (saddle nose deformity).
• Crooked (deviated) nasal septum. The nasal septum is the structure that divides the nose into two parts. See a picture of a deviated nasal septum.
• Permanent breathing difficulty.
• Persistent drainage from one or both nostrils. This may be caused by cerebral spinal fluid draining from the brain into the nose (CSF rhinorrhea) and can occur after a head injury or after surgery on the nose or ears.
• Infection of the nose, sinuses, or facial bones.
• A change in or loss of sense of smell.

How is a broken nose diagnosed?

A broken nose is diagnosed through a physical examination and medical history. An X-ray of the nose is not usually needed or helpful if only a broken nose is suspected. If other facial injuries or fractures are suspected, a CT scan will be done. Your doctor may wish to delay evaluation until the swelling has gone down. This may take several days.

How is it treated?

Immediately after the fracture, apply ice and keep your head elevated. You may need pain medicine, such as acetaminophen (for example, Tylenol). Be safe with medicines. Read and follow all instructions on the label. Do not take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil or Motrin) or aspirin, for 48 hours after a nose injury. Do not take aspirin if you are younger than 20 because of the risk of Reye syndrome.

Immediate treatment is needed for some injuries that occur with a broken nose, such as:

• A large amount of blood in the nasal septum (nasal septal hematoma).
• A nosebleed that you cannot stop (epistaxis).
• Clear drainage from one or both nostrils (CSF rhinorrhea).

Treatment, if needed, usually is done within 7 to 14 days of breaking your nose. Most broken noses do not require treatment other than controlling pain and other symptoms.

• Your doctor may treat a simple fracture by straightening the bone or cartilage in your nose, if it is crooked. Splints or nasal packing (packing the nose with gauze) also may be necessary.
• Surgery may be needed to treat a more complicated fracture. Your doctor may need to move the bone or cartilage back into place. Splints or nasal packing may be necessary. Antibiotics are usually given to prevent infection. Your nose may be rechecked and the packing may be removed in 48 to 72 hours.