Nasal Fracture

Vincent D. Tjiptadi, Mendy Oley Plastyc Surgery Division of Surgery Department Medical University of Sam Ratulangi / Prof dr.R. D. Kandou Hospital Manado

Background Nasal fracture is a fracture of one of the bones of the nose. Because the protrusion of the nose from the face and the fragility of the bones to the nose, nasal fracture is one of the most common facial injuries, comprising almost 40% of all facial injuries. Nasal fractures are caused by physical trauma to the face include sports injuries, fighting, falls and trafic accident. The symptoms include ruising, swelling, tenderness, pain, deformity and bleeding. There are three categories of nasal fracture: Class I, fracture limited to the nasa bone; Class II, fracture involved the nasal septum, frontonasal process of maxilla with roof of ethmoidal labyrinth and orbit remains intact; Class III, is a class II fracture with roof of ethmoidal labyrinth and orbit involved also known as naso orbital fracture and always associated with Le Fort fractures of upper face. Case report A 9 years old girl suffered a fracture of nasal bones caused by traffic accident 5 hours before admition with history of unconssiousnes and apnue caused by airway obstructions. In physical examination we found a periorbital echimosis, laceration of the skin and deformity of nasal bone and crepitus in palpation. In x-rays we found a fracture line of the nasal bone depressed to the nasal cavitiy with fracture line through the septum and orbital roof. We perform closed reduction with Walshams forceps and open reduction. Conclucion Severe nasal fracture can cause the airways obstruction therefore intial assesment for the airway is needed. The closed reduction with open reduction of the fracture gives a better result than just one procedure.