Nasal Trauma – Fractures
Because the nose is the most prominent part of the face, it is the most commonly fractured facial bone. Sports injuries, falls, traffic accidents and assaults are the usual causes. Timely assessment is the key to preventing both deformity and permanent obstruction.
Signs of a nasal fracture
- Nosebleed after the impact
- Deformity — deviation or collapse of the nasal bridge
- Swelling and bruising (may spread around the eyes), tenderness
- Blocked nose, a grating sensation of bone movement
An emergency: septal hematoma
This is a collection of blood between the layers of the nasal septum after trauma. It appears as purple-red bulges on both sides inside the nose with rapidly progressive total blockage. If not drained within hours, the cartilage melts away and the nasal bridge collapses (saddle nose). For this reason the inside of the nose must be examined in every nasal trauma patient — especially children.
Why timing is critical
- First few hours: if assessed before swelling sets in, the bones can sometimes be repositioned immediately.
- Once swollen: wait 3–5 days for the swelling to subside, then re-assess.
- Reduction window: closed reduction is possible within about 10–14 days in adults and 7 days in children; after that, the bones heal in the wrong position.
Treatment
Closed reduction: displaced bones are repositioned without incisions, under local or brief general anaesthesia, and stabilised with a splint. Late or complex cases: once bones have healed crooked, lasting correction requires septorhinoplasty. Post-traumatic deviation and obstruction call for surgical planning that addresses function and appearance together; correcting previously unsuccessful nasal surgery is a particular interest of mine.
When to seek emergency care
Uncontrollable bleeding, clear watery discharge (possible CSF leak), visual problems, suspected fractures of other facial bones, or signs of septal hematoma — go without delay.
Frequently Asked Questions
What are the signs of a broken nose?
Typical signs are a nosebleed after the impact, a deformity such as deviation or collapse of the nasal bridge, swelling and bruising that may spread around the eyes. Tenderness, a blocked nose and a grating sensation of bone movement can also be present.
How long can you wait for nasal fracture treatment?
There is a window for repositioning the bones (closed reduction): about 10-14 days in adults and 7 days in children. After this period the bones heal in the wrong position and a more extensive surgery may be needed to correct them.
What is a septal hematoma and why is it dangerous?
A septal hematoma is a collection of blood between the layers of the nasal septum after trauma, appearing as purple-red bulges on both sides inside the nose with rapidly progressive total blockage. If it is not drained within hours the cartilage melts and the bridge collapses (saddle nose), so the inside of the nose must be examined in every trauma patient.
How is a broken nose treated?
Displaced bones are repositioned without incisions under local or brief general anaesthesia and stabilised with a splint, a procedure called closed reduction. In late or complex cases where the bones have already healed crooked, lasting correction may require septorhinoplasty.
When should I seek emergency care after a nasal injury?
Seek emergency care without delay if there is uncontrollable bleeding, clear watery discharge (a possible CSF leak), visual problems, suspected fractures of other facial bones, or signs of a septal hematoma. These situations need urgent assessment.
Would you like to book an appointment?
You can call our office or pick a convenient time slot on DoktorTakvimi.