The following document was written by Mr Vik Veer MBBS(lond) MRCS(eng) DoHNS(eng) in Dec 2007. You may use the information here for personal use but if you intend to publish or present it, you must clearly credit the author and
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Nasal Fractures

A fractured nose is normally obvious immediately after the injury occurs. However, if a patient is seen two hours after the injury, there is normally so much swelling that it is difficult to be sure whether the nasal bones are fractured or not. This swelling generally has almost subsided by day 5 - 7. Within 14 – 18 days later nasal bones have probably already set.
So in an uncomplicated patient what you need to do is book the patient in to see the ENT team in their emergency clinic (or the local alternative) about 5-7 days after their injury.
This will allow the ENT team to properly assess the patient once the swelling has subsided, and also give them enough time before the 2 week deadline to book them in for a manipulation of nasal bones. This involves a quick anaesthetic and the bones pushed back into place so that they can set and heal in a more anatomically correct position.

There are some things to check before you discharge the patient though.
Make sure you have covered the obvious but easily missed things:

Then move on to the more ENT related aspects – remember to check for:


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Further Reading

eMedicine - Nasal and Septal Fractures : Article by Adam T Ross

eMedicine - Nasal Fracture : Article by Samuel J Haraldson