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Definition

A nose fracture is a break in the bones of the nose.

Facial Bones
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Causes

A nose fracture is caused by a blunt, hard blow to the nose. It often occurs along with injuries to other parts of the nose and face.

Risk Factors

Factors that may increase your chance of a nose fracture include:

  • Any condition that causes frequent falls, such as:
  • Previous nose fracture or nose injury
  • Participating in sports, especially contact sports
  • Reckless behavior during recreational activities or driving
  • Failure to wear a seat belt —keep in mind that airbags can also sometimes cause injury

Symptoms

A nose fracture may cause:

  • Pain in the bridge of the nose
  • Inflammation of the nose or surrounding area of the face
  • Bleeding from the nose (often heavy)
  • Difficulty breathing through the nose or nostril
  • Discoloration of the nose
  • Black eyes

Diagnosis

The doctor will ask about your symptoms and how the injury occurred, and will examine your nose and face for:

  • Irregularities in the shape
  • Movement of the bones of the nose and face
  • Rough sensation when your nose is moved
  • Pain or tenderness to touch at the nasal bridge
  • Injury to the nasal septum (especially hematoma)
  • Any fluid from the nose, such as blood or cerebrospinal fluid (in severe cases)

Although not necessary, imaging tests may be done to confirm the fracture, and check its location and serverity. They usually are not done until the inflammation goes down. Imaging tests may include:

Treatment

Treatment depends on the severity of the fracture. If your nose is broken and in position, the only treatment you will need is home care. It is important to be careful to not bump your nose while it heals. More severe fractures may need realignment or surgery.

Ice

Ice helps reduce inflammation and pain. Apply an ice pack to your nose for 15-20 minutes at a time. Place a towel between the ice pack and your skin.

Medication

Prescription or over-the-counter medications may be given to help reduce inflammation and pain.

Realigning the Bones

If it is determined that your nose is out of position, obstructing your breathing, or causing other problems your doctor may:

  • Drain any blood that may have collected in or around the septum
  • Set the fracture by:
    • Moving the bone back to its normal position after the inflammation has gone down
    • Stabilizing the bone with gauze packing on the inside and a splint or tape on the outside

Surgery

Surgery may be needed to set the fracture if:

Surgery may be needed to set the fracture if:

  • The fracture is severe and will not heal without surgery
  • The nose is severely misshapen
  • The fracture impairs breathing

Prevention

Nose fractures may not always be preventable, but you can reduce your risk:

  • Wear protective headgear with face masks when playing contact sports, or when riding a bicycle or motorcycle
  • Wear a seat belt when driving or riding in a car
  • Avoid situations that may involve fights

Revision Information

  • American Academy of Cosmetic Surgery

    http://cosmeticsurgery.org

  • Family Doctor—American Academy of Family Physicians

    http://familydoctor.org

  • The Canadian Society of Plastic Surgeons

    http://www.plasticsurgery.ca

  • The College of Family Physicians of Canada

    http://www.cfpc.ca

  • Fractures of the nose. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/injuries%5Fpoisoning/facial%5Ftrauma/fractures%5Fof%5Fthe%5Fnose.html. Updated March 2013. Accessed August 21, 2014.

  • Nasal fractures. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/nasal-fractures. Accessed August 21, 2014.

  • Ondik MP, Lipinski L, et al. The treatment of nasal fractures: a changing paradigm. Arch Facial Plast Surg. 2009;11(5):296-302.

  • Rosen P, Marx JA, Hockberger RS, Walls RM, Adams J. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, PA; Mosby Elsevier; 2006.

  • Rother T, Riechelmann H, Gronau S. Secondarily accelerated foreign bodies as a source of danger from airbag deployment. HNO. 2006;54:967-970.