Nasal bone fractures are the most common among facial fractures. Usually these are adequately treated with closed reduction and internal and/or external stabilization with splints. However, there are clinical situations where the nasal bones are severely displaced, the nasal septum fractured and displaced, or there are external drape lacerations which preclude the use of nasal splints. If the nasal bones are reducible but unstable we consider them “flail” and in this case transmucosal, endonasal Kirschner wires are used for dorsal support until sufficient healing occurs. The technique is simple, quick, and predictable and causes minimal discomfort to the patients.
Facial injury as a result of an industrial accident from a stationary saw is rather uncommon; however, such an injury can result in significant damage to vital structures in the maxillofacial region and can even be life-threatening. Expeditious and prompt treatment at the time of such penetrating facial injury results in a favorable outcome. Appropriate care and proper treatment of a patient with penetrating facial injury includes immediate clinical assessment, diagnostic imaging, early wound exploration, removal of the foreign body, wound debridement, repair of hard and soft tissue, and adjunctive antimicrobial therapy.
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