Nasal bone fractures are the most common facial trauma because the nose protrudes from the face. A frontal or lateral force can cause a nasal bone fracture depending on the magnitude. There are two main types - depressed fractures which result from a frontal blow causing the nasal bones to collapse inward, and angulated fractures from a lateral force which cause deviation of the nasal bridge. Clinical features include nasal swelling, bruising around the eyes, tenderness, deformity, and occasionally nosebleeds or nasal obstruction. Diagnosis is usually made through physical exam but x-rays can help show the fracture, though may sometimes miss it. Treatment depends on if there is displacement - non-displaced fractures may need no treatment, while displaced

1. NASAL BONE FRACTURE
NUR HANISAH
BINTI ZAINOREN

2. TRAUMA TO THE FACE
LOWER THIRD
Mandible and
lower teeth
MIDDLE THIRD
Between the
supraorbital
ridge and the
upper teeth
UPPER THIRD
Above the level of
supraorbital ridge

3. TRAUMA TO THE FACE
LOWER THIRD
Mandible and
lower teeth
MIDDLE THIRD
Between the
supraorbital
ridge and the
upper teeth
UPPER THIRD
Above the level of
supraorbital ridge

4. TRAUMA TO THE FACE
LOWER THIRD
Mandible and
lower teeth
MIDDLE THIRD
Between the
supraorbital
ridge and the
upper teeth
UPPER THIRD
Above the level of
supraorbital ridge

5. Fractures of nasal bones are the most
common trauma to the face because of
the projection of nose on the face
Traumatic force
may act from the
front or side
Magnitude of force
will determine the
depth of injury

6. Types of
Nasal Fractures
depressed angulated

7.  Due to frontal blow
 Lower part of nasal bones
(thinner), easily gives way
 Severe frontal blow will cause
“open-book fracture” 
nasal septum is collapsed
and nasal bones splayed out
 Greater force  comminution
of nasal bones and even the
frontal process of maxillae
with flattening and widening
of nasal dorsum
DEPRES

10. ANGULAT
EDDue to lateral blow
May cause:
 Unilateral depression of
nasal bone on the same
side
 Fracture both nasal bones
& septum with deviation
of nasal bridge
nasal fractures are often accompanied
by injuries of nasal septum
(buckled, dislocated, or comminuted)

13. CLINICAL
FEATURES
Swelling
of nose
Periorbital
ecchymosis
Tenderness
Nasal
deformity
Crepitus
Epistaxis
Nasal
obstruc-
tion
Lacerations
of nasal
skin

15. DIAGNOSIS
• Best made on physical
examination
• Xray:
– may or may not show
fracture
– Patient should not be
dismissed as having no
fracture because xrays did
not reveal it
– Should include Water’s view,
right & left lateral view and
occlusal view

16. TREATMENT
• Simple fracture with no displacement  NO
TREATMENT
• Closed reduction
– Interfered by presence of oedema
– Best time is before the appearance of oedema, or
after it has subsided (usually 5-7 days)
– Difficult after 2 weeks because it heals by that time
• Open reduction (rare)

17. REFERENCES
• Diseases of Ear, Nose and Throat & Head and
Neck Surgery, 6th Edition, PL Dhingra, Elsevier
• https://www2.aofoundation.org/wps/portal/!ut/
p/a0/04_Sj9CPykssy0xPLMnMz0vMAfGjzOKN_A0
M3D2DDbz9_UMMDRyDXQ3dw9wMDAzMjfULsh
0VAbWjLW0!/?bone=CMF&classification=92-
Nasal%2FNOE%2C%20Nasal%20bone&segment=
Midface&showPage=diagnosis&teaserTitle=&con
tentUrl=/srg/92/01-Diagnosis/nasal.jsp

18. THANK YOU