Broken Nose (Fracture Nose)-Part 2

Treatment of Fracture Nose in Children

Injuries to the nose are relatively common; in cases of facial trauma, nasal fractures account for approximately 20 percent of bone injuries. Nasal fractures may occur in isolation or in association with other facial injuries
A nasal fracture is also called a broken nose. This occurs when any of your child’s bones in the nose are broken. Nasal fractures are the most common facial fractures since the nose is a prominent part of the face.
Causes of nasal fracture
A nasal fracture in children is caused by an injury or trauma to the nose. This usually happens when a child falls from a high place and lands on his face. He may have fallen from a bed or down the stairs. Most injuries occur while the child is playing. A direct blow to the nose may also cause a nasal fracture. This may occur during a fight, physical abuse, car accident, or in contact sports.
Signs and symptoms of a nasal fracture
child may have one or more of the following:
• Blockage of one or both nostrils.
• Cut, bruise, swelling, or bleeding in his nose, or bruising around his eyes (black eyes).
• Deformed nose that is moved towards one side of the face.
• Grating sound or feeling when the nose is touched or rubbed.
• Headache, or pain on his nose or face.
• Trouble breathing

Treatment
Treatment will depend on the damage and the type of fracture your child has. Most nasal fractures heal more rapidly among children than in adults. The younger your child is, the faster the fracture will heal without further problems. Your child may need one or more of the following:

• Closed reduction: Caregivers may realign the broken bones or bring the nose back to its original position. This is done by moving the nasal bones and septum without opening the skin.Your child’s nose may need to be fixed or supported with splints. A splint may be placed inside or over the top of his nose.Caregivers may give your child medicine to help ease his pain. Your child may need antibiotic medicine or a tetanus shot if the bone has broken through his skin. Medicines may also be given to decrease swelling in your child’s nose and make breathing easier.
Nasal packing: Caregivers may pack your child’s nose with gauze (bandage) strips to control bleeding and prevent infection. These strips are moistened (wet) with salt solution or antibiotic ointment.
Surgery: Your child may need surgery to return the bones to their normal position if the fracture is bad. Surgery may also be needed to correct a deformity or fix damaged tissues on the nose. Blood clots in the nose may be removed by making a small incision in your child’s nose. Injury to the other parts of the nose, nerves, or blood vessels may also be treated with surgery.

What first-aid should be done for a nasal trauma?

You may do the following if your child has a nasal trauma:
• Have your child breathe through his mouth and lean forward to keep blood from going down the back of his throat.
• Ice may be applied on the swollen part to decrease swelling, pain, and redness.
• If your child’s head is bleeding, apply a direct pressure with a clean cloth. Place another cloth if the original cloth gets soaked with too much blood.

Dr Paulose is an ENT Consultant Plastic and Laser Surgeon with over 35 years of experience covering in Ear, Nose and Throat procedures, specializing in Laser Surgery and conventional medicine across India, U.K. and Middle East. He is currently engaged with the Jubilee Hospital, in Kerala, India.