Patterns of Referral for Fractured Nose During Major Sporting Events

Abstract

Ann RC oll Surg Engl 2008; 90:6 89-691 689Fractured nose is one of the more common acuted iagnoses managed by ENTd epartments: 9400 manipulations under anaesthesia were undertaken in England during 2005-2006. 1 Whiled etailed national figureso na etiology ared ifficult to obtain, it is generallya ccepted that violent trauma between individuals is the mostcommoncausative factor in adults.Patients with this conditionwill commonly present to their local ear,n ose and throat (ENT) service via an accidenta nd emergency (A&E)d epartment or their general practitioner (GP). Ac areful internal and external nasal examination is required to assesst he degree of injury or dislocation of nasal bones and cartilages, and thereby plan appropriate intervention. Within hours of injury,t he area will be obscured by swelling; therefore, accepted ideal practicef or the receiving ENT servicei st ou ndertake af ull assessment 7d aysp ostinjury,o nce swelling has reduced.T his allowsaf urther 8-12 days forintervention before any fractured facial bonesbecome fixed in an abnormal position.An unusual pattern of referrals was noted during 2006, prompting am ore thorough examination of these referral patterns in recent years. Patients and MethodsData were obtained from two similarly-sizedENT centres in west London, based at Charing Cross Hospital in Fulham, andN orthwick Park Hospital in Harrow.E ach receives referrals directly from three A&E departments, and an umber of NHS walk-in centres; takentogether,they serve apopulation of approximately one million. Both operate asystemwhereby oncalls taff may make appointments for subsequent emergency clinics by recording the details of an acutely-referred patient in ah ard-back diary; figures wereo btainedf rom these diaries. The recorded datac oncerned only adults, as both centres make alternative arrangements for paediatric patients. Regrettably,a sd emographic data were not recorded to any consistent standard, these could not be included.

Is there a change in the epidemiology of nasal fractures in females in the UK?

“…1 The nose is the most exposed part of the body and the one least protected. In addition, there are significant emotional, functional and cosmetic repercussions associated with nasal trauma.…”

“…Nasal fractures represent one of the more common acute diagnoses managed by ENT departments 1 . The nose is the most exposed part of the body and the one least protected.…”