The most common facial fracture, a fractured nose usually results from blunt injury and is commonly associated with other facial fractures. The severity of the fracture depends on the direction, force, and type of the blow.
A severe, comminuted fracture may cause extreme swelling or bleeding that may jeopardize the airway and require tracheotomy during early treatment. Inadequate or delayed treatment may cause permanent nasal displacement, septal deviation, and obstruction.
With low-energy injuries, noncomminuted nasal bone fragments are caused by low-velocity trauma. Such injuries could occur in the following situations:
injuries created during fistfights (hand or fist blows only, no blunt instruments)
uncomplicated falls such as tripping
low-velocity motor vehicle collision.
With high-energy injuries, a higher amount of energy is absorbed by the nasal and facial bones, with comminution of bone fragments and associated injuries to the soft tissue and orbitonasal skeleton. These injuries would include:
injuries sustained from a leveraged blow to the nose using an object such as a stick, pipe, or other blunt object
falls from heights
sport injuries with fast-moving projectiles, such as a ball or puck
high-velocity motor vehicle collisions.
Signs and symptoms
Immediately after the injury, a nosebleed may occur, and soft-tissue swelling may quickly obscure the break. After several hours, pain, periorbital ecchymoses, and nasal displacement