View source for Nasal fracture

==Background==
*Always assess for associated head, face, and neck injuries

==Clinical Features==
*Nasal deformity, bony crepitus
*Profuse epistaxis
*Periorbital ecchymosis in the absence of other findings of orbital injury

==Diagnosis==
*Clinical diagnosis (imaging rarely needed)

==Differential Diagnosis==
{{Maxillofacial trauma DDX}}

==Treatment==
#Exclude other associated traumatic injuries
#Treat septal hematoma
##Immediately incise and drain
#Most nasal fractures do not require immediate intervention
##Can be managed by outpt ENT within 6-10d
##Consider ED reduction only if pt presents before significant swelling has occurred
###Anesthesia
####Place lidocaine soaked cotton pledgets for 5min
####Inject local anesthetic
####Perform [[Nerve Block: Infraorbial]] and [[Nerve Block: supraorbital]] if needed
###Reduction
####Insert elevator until contact is made with the depressed nasal bone
####Lift depressed nasal bone anteriorly and laterally in one fluid motion
####Use external splinting and/or nasal packing to maintain alignment

==Disposition==
#Refer to ENT within 6-10d regardless of whether perform reduction or not
#No nose blowing

==Source==
Tintinalli

[[Category:Trauma]]
[[Category:ENT]]