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Reposition and fixation of nasal bones in case of fracture
Among the facial injuries broken nose occurs most often. This injury can result in damage to the olfactory and respiratory functions.
Usually this phenomenon occurs in everyday conditions: a fall on a slippery floor, ice, a fight, but there is also a risk group – people, including athletes and motorists.
The procedure by which organ dysfunction during a fracture is eliminated is called repositioning of the nasal bones.
To understand what a nasal fracture can be, you should know about its structure. The nose borders the skull at the top, the oral cavity at the bottom and the eye sockets at the sides.
Structure of the nose
The outer wall, also called the lateral wall, includes the nasal bone, palatine bone, nasal surface of the upper jaw, ethmoid bone, pterygoid processes of the main bone, frontal process and lacrimal ossicle. The side walls are connected by a partition.
The posterosuperior part includes the vomer and the perpendicular plate of the ethmoid bone.
In front below there is a quadrangular cartilage and a movable part of the septum.
The upper wall is formed by a thin cribriform plate, which is easily damaged by injury.
On the side of the nose are the large and small alar cartilages.
Most often we can deal with injuries in the external nasal bones; injuries to the walls of the orbits, vomer, frontal processes and nasal turbinates are rare.
Types of nasal bone fractures
- Closed nasal fracture – visible manifestations are mild (abrasions and swelling).
- An open nasal fracture is characterized by wounds on the skin and bone fragments can be seen.
- Displaced nasal fracture – the nose becomes asymmetrical (may be accompanied by external damage to the skin or have the characteristics of a closed shape).
- Damage to the nasal septum – the nose falls inward.
Symptoms of a nasal fracture
How to recognize a broken nose:
- blood flows (there may be either copious or scanty discharge);
- shock and loss of consciousness are possible;
- the skin around the nose, eyes and cheekbones becomes swollen;
- red veins are visible in the eyeballs;
- difficult to breathe, frequent blowing of the nose;
- there are wounds, sometimes fragments are visible;
- the nose hurts, touching it causes acute pain;
- There were bruises at the site of injury and under the eyes.
In addition to the primary signs that appear during the first day after a fracture, there may be an increase in temperature, redness at the fracture site, and softening of the tissue. Such manifestations on the second or third day after injury indicate infection of the wounds by pathogenic microorganisms.
Diagnosis of nasal fracture
- using rhinoscopy, areas of soft tissue rupture are determined;
- to determine the presence of displacement, the patient is given an x-ray of the lateral part of the nose;
- Inspection of internal damage is carried out using an endoscope;
- The patient is prescribed laboratory tests of blood and urine.
After diagnosis, the doctor prescribes treatment that suits the individual case.
Treatment of a broken nose
First aid for a broken nose
involves applying a cold compress (ice) to the injured area to relieve swelling and reduce pain.
For severe pain, the patient is given painkillers and sedatives.
A tetanus vaccination is given.
If the bones have moved or crumbled due to a fracture, reposition.
Reposition of the nasal bones is carried out in a limited time. No more than 21 days should pass from the moment of injury to the bone realignment procedure. The optimal time for the operation is from 5 hours to 7 days.