Fracture of the nose is the commonest fracture in humans.
Epidemiology:
More common in Caucasians than Asians or Africans.
Aetiology:
Usually low velocity trauma to the nose is the common cause. This may result from:
Personal assault.
Sports injuries.
Road traffic accidents.
Personal accidents.
Types of fracture:
Class I: Blow of severity due to frontal or fronto-lateral trauma. There is a breach in the quadrilateral cartilage with depression or displacement of distal part of nasal bone.
Class II: Medium velocity lateral trauma. There is a breach in root of nasal bone and maxillary process of frontal bone. The ethmoid labyrinth is intact.
3.Class III: High velocity trauma. Fracture extends to the ethmoid labyrinth. The patient has pig-like appearance. Injury to lacrimal sac and nasolacrimal duct may be present.
Clinical features:
Swelling of nose.
Periorbital ecchymosis.
Tenderness.
Nasal deformity: Depressed from the front or side, or the whole nasal pyramid deviated to one side.
Crepitus and mobility of fractured fragments.
Epistaxis.
Nasal obstruction due to septal injury or hematoma.
Lacerations of the nasal skin with exposure of nasal bones and cartilage may be seen in compound fractures.
Diagnosis:
Diagnosis is best made on physical examination.
X-rays may or may not show fracture.
Complications:
Deviated nasal septum.
Saddling of the nose.
Bleeding.
Cerebrospinal fluid leak.
Orbital complications.
X ray nasal bone lateral view show fracture of nasal bone.