Your Health - Nose Fracture

Nose Fracture

(Broken Nose)

Definition

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

Facial Bones

Causes

A broken nose 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

A risk factor is something that increases your chance of getting a disease, condition, or injury. Risk factors for a nose fracture include:

Previous nose fracture or nose injury
Participating in sports (especially contact sports)
Reckless behavior during recreational activities or driving
Failure to wear a seatbelt (but airbags can also sometimes cause injury)

Symptoms

Symptoms of a broken nose include:

Pain in the nose or surrounding area of the face
Swelling 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
Crooked or misshapen appearance of the nose (may not appear until swelling subsides)

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
Injury to the nasal septum (especially hematoma)
Any fluid from the nose (such as blood or even cerebrospinal fluid in severe cases)

Tests may include:

X-rays of the nose—usually not necessary, but may be used to confirm the fracture and check its location and severity.
CT scan —usually not necessary, but may be used to confirm the fracture and check its location and severity.

Treatment

Treatment includes:

Ice

Apply ice or a cold pack to your nose for 15 to 20 minutes, several times a day for several days. This helps reduce pain and swelling. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.

Medication

The following drugs help reduce inflammation and pain:

Ibuprofen (Motrin, Advil)
Naproxen (Aleve, Naprosyn)
Acetaminophen (Tylenol)
Aspirin

Setting the Bones

The doctor may:

Drain any blood that may have collected in the septum
Set the fracture by:
- Moving the bone back to its normal position
- 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:

The fracture is severe
The nose is severely misshapen
The fracture impairs breathing

If you are diagnosed with a nose fracture, follow your doctor's instructions .

Prevention

Broken noses may not always be preventable. To reduce your risk of a broken nose:

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.

RESOURCES:

American Academy of Cosmetic Surgery
http://www.cosmeticsurgery.org/index.cfm/

American Academy of Family Physicians
http://www.aafp.org/online/en/home.html/

CANADIAN RESOURCES:

Canadian Family Physician
http://www.cfpc.ca/cfp/

The Canadian Society of Plastic Surgeons
http://www.plasticsurgery.ca/

References:

American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html . Accessed July 16, 2009.

Berkow R. The Merck Manual of Medical Information . New York, NY: Pocket; 2000.

Nasal fracture. National Center for Emergency Medicine Informatics website. Available at: http://www.ncemi.org/cse/cse0310.htm . Accessed July 21, 2009.

Nose fracture. National Library of Medicine, Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000061.htm . Updated January 2008. Accessed July 16, 2009.

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.

Last reviewed October 2009 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.