Fracture of the bones of the nose - Causes, symptoms and treatment. MF.

The nose consists of the osseous part and the cartilaginous part. The back of the nose is formed by the nasal bones and frontal processes of the upper jaw, and the tip and wings of the nose are represented by a cartilaginous tissue. The nasal septum in the anterior part has a cartilaginous skeleton, and in the posterior part - bone. Often, injuries, both unexpected and accidental, and deliberate and criminal, lead to a fracture of the bone or cartilaginous skeleton of the external nose and its septum. Unseen it can not pass, because as a result of this all the functions of the nose - from the olfactory and respiratory to the aesthetic. It is important to seek qualified help in a timely manner.

Fracture of the bones of the nose is a common trauma of the facial area( up to 40% of cases).

The main cause of a fracture of the nose is his injury. The mechanism of injury is a direct or lateral impact with a solid blunt object or a blow against a hard surface. Most often, a fracture of the bones of the nose occurs in sports, street fights, in falls and in an accident.

Symptoms of a fracture of the bones of the nose

is distinguished by a fracture of the nose with or without offset, as well as open and closed fractures of the bones of the nose. As with any closed fracture of bones, the integrity of the skin in the region of the nose is not impaired. With an open fracture, there is skin damage, while in the wound can be determined bone fragments( crushing).

Symptoms of fracture of the bones of the nose :

• Bleeding from the nose. It is worth noting that with a nose injury, after which no nosebleed bleeding is about the fracture, it does not go. It is more a bruise of soft tissues without damage to the skeleton. This does not mean that any bleeding from the nose - this is a sign of a fracture.
• Pain with nose palpation and sharp edema in the area of ​​the impact and under the eyes.
• Over time, there are bruises around the nose and under the eyes - a symptom of "glasses".
• Changes in the shape of the nose, its displacement or zapping.
• Difficulty with nasal breathing.

Causes of fracture of the nose bones

The nose is the most outstanding part of the face, therefore it is injured more often than other formations of the facial area.40% of all injuries in this area are trauma to the nose, incl.and its fracture.

The most common reasons:

• Sports injuries - boxing, hockey, martial arts with shock equipment.
• Household injuries and street fights.
• Accidents and industrial accidents.
• Falls.

Nose fracture complications

Injuries to the nose, incl.and fracture of the bones of the nose often leads to the curvature of the nasal septum. As described in the relevant sections, this pathology leads to a disruption of nasal breathing, and then to chronic rhinitis and sinusitis. In this situation, surgical treatment is necessary. Other possible complications include a fracture of the cartilage of the nose, craniocerebral trauma, up to the fracture of the base of the skull( which often results in a fatal outcome) and hematoma of the septum( which is fraught with suppuration and melting of the cartilage).In all these cases, it is vital to seek medical help.

Diagnosis of a fracture of the nose bones

Diagnosis begins with communication with a doctor who will determine the nature of the injury. On examination, changes in the shape of the nose and marked swelling at the site of the stroke can be determined. With palpation( palpation), crepitation of fragments( crunch) and pronounced pain sensations can be determined. When rinsoscopy it is possible to establish the places of rupture of the mucous membrane of the nasal cavity. In the absence of visible displacements of the nose, it is necessary to perform a radiography of the bones of the nose in the lateral projection. After specifying the dysgnosis( displacement - no bias), the question of repositioning the bones and further tactics of the patient's management is being decided.

Treatment of a fracture of the bones of the nose

In the first minutes after the injury( if possible), it is necessary to apply cold to the area of ​​the nose. This will prevent the appearance of severe swelling and, possibly, contribute to stopping nasal bleeding.

Tactics of treatment depend on the nature of fracture of the bones of the nose and other associated injuries. If, after the injury, no more than 7 days have passed, then the reposition of the bones manually( reposition - the installation of fragments in its place). The reposition is performed under local anesthesia. An anesthetic solution( lidocaine) is irrigated with the mucous membrane of the nasal cavity, and an intradermal injection is made from the outside. Sometimes it is possible to place the bones in place with two finger movements. In case there is an abnormality of the bone, a special tool is used - elevator( elevatio).The ejector is inserted into the nasal cavity and the sunken part of the bone is raised and compared to other bone parts of the skeleton of the nose. Soreness with this manipulation can not be avoided, however, anyone can survive a few seconds of not the most acute pain. Then, tampons are installed in the nasal cavity for tight pressing and "supporting" the skeleton of the nose. Tampons are in the nose for about 3 days.

Strongly unacceptable self-direction, becauseInept movements can only lead to additional traumatization of soft tissues with bone fragments.

After a long time after the injury, when the edema subsides, it may become clear that not only the respiratory, but also the aesthetic function of the nose has been affected. In such cases, surgical treatment( rhinoplasty) is performed. At the same time, it may be necessary to restore nasal breathing, by correcting the curved nasal septum. In such cases, perform a large operation - rhinoseptoplasty. These interventions can be performed by both an ENT doctor and a plastic surgeon.