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.