Closed Reduction of Nasal Fracture

The nasal bone is the most commonly fractured bone in facial trauma and the third most commonly fractured bone overall (The Journal of Craniofacial Surgery 23:1848–1850, 2012; American Journal of Otolaryngology 26:181–185, 2005). Nasal bone fractures can produce significant aesthetic deformity and compromise the patency of the upper airway. Consequently, intervention is indicated to minimize deformity and functional impairment. Simple, noncommunited nasal bone fractures are managed with a closed approach (Seminars in Plastic Surgery 24:339–347, 2010). An instrument is inserted into the nasal cavity, and external digital pressure is applied over the fracture location. The nasal bone is then manipulated between the digit and elevator until properly positioned. The septum, if displaced, is realigned using an Asch’s forceps. Internal and external splints are placed to stabilize and protect the nasal bones. Complications include obstructed breathing and need for a definitive rhinoplasty.