Analysis of Nasal Bone Fractures; A Six-year Study of 503 Patients

Abstract

The aim of this study is to classify the nasal bone fractures based on computed tomography (CT) analysis and patterns of the nasal bone fractures, and review 503 cases treated between 1998-2004 at the Department of Plastic Surgery, Inha University Hospital, Incheon, South Korea. The age, sex, etiology, associated injuries, pattern of fractures and treatments were reviewed and a radiographic study was analyzed. Plain simple radiographs of lateral and Waters view of the nasal bones combined with computed tomography scans were done. Nasal bone fractures were classified into six types: Type I) Simple without displacement; Type II) Simple with displacement/without telescoping; IIA; Unilateral; IIAs) Unilateral with septal fracture; IIB) Bilateral; IIBs) Bilateral with septal fracture; Type III) Comminuted with telescoping or depression. Diagnosis of nasal bone fractures were made positively by plain x-ray films in 82% of cases, negative finding was 9.5% and 8.5% of cases were suspicious of the fractures. Reliability of the plain film radiographs of the nasal bone fracture was 82% in this study. In the most of the fractured nasal bones (93%) the closed reduction was done, open reduction in 4% and no surgical intervention in 3%. Nasal reduction was carried out in average 6.5 days post the injury. The patterns of the nasal bones fractures classified by CT findings were type IIA (182 cases, 36%), IIBs (105 cases, 21%), IIB (90 cases, 18%), IIAs (66 cases, 13%), I (39 cases, 8%) and III (21 cases, 4.3%). We think the CT is necessary for diagnosing nasal bone fracture because the reliability of the plain film was only 82%.

Patterns of Maxillofacial Fractures in Road Traffic Crashes in an Indian Rural Tertiary Center

“…14 Hwang et al evaluated 503 nasal bone fractures using lateral and Water's view, and only 82% of nasal bone fractures were identified. 15 Computed tomography scan is the preferred imaging modality for multiple and complex maxillofacial injuries, it offers excellent bone details, especially in case of midface fractures which have a complex anatomy and also to evaluate associated head injury. 15 Most of our patients were evaluated by axial sections of CT scan.…”

“…15 Computed tomography scan is the preferred imaging modality for multiple and complex maxillofacial injuries, it offers excellent bone details, especially in case of midface fractures which have a complex anatomy and also to evaluate associated head injury. 15 Most of our patients were evaluated by axial sections of CT scan. Coronal sections were used in patients who are stable and with no cervical spine injury.…”

An analysis of 45 patients with pure nasal fractures

“…Another study showed similar mean age. [14] It was speculated that subjects in this age peak were becoming more involved in the same activities. We also observed physical aggression was encountered more between 20 and 30 years.…”

Epidemiological Analysis of the Nasal Trauma

“…The topography of the nasal pyramid according the age group and the gender, the results as follows; in the age group (0-10), most common nasal pyramid topography was no deformity and it's found in (80%),while in the reminder age groups, the most common nasal deformity was sided deviation, as follows; in age group (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) it was (63.15%), in age group (21-30) years, it was (50%), in age group (31-40), it was (77.77%), as it shown in table 3. The relationship between the mechanism of the trauma and the topography of the nasal pyramid, it reveled that; regarding falling as the etiological factor, the most common type of nasal pyramid topography was no deformity, in the reminder etiologies, the most common nasal pyramid topography was sided deviation, as follows; in case of accident apart from fall there were 16 patients (47.05%), in personal assault; there were 20 patients (55.55%), in road traffic accident, there were 16 patients (53.33%) ,and in sport injury; there were 8 patients (80%) as shown in table 4.…”