First aid for a broken nose

How to provide first aid for a broken nose?

1. Breathe through your mouth.
2. If there is a risk of injury to your neck or spine, do not move. Have someone else call 911.
3. If your neck is fine, lean forward and gently pinch your nostrils together. This will help stop the bleeding and prevent blood from going to the back of your throat and being swallowed.
4. Apply a cold compress to reduce pain and swelling.
5. You can take an over-the-counter pain reliever if the pain is severe. But when you go to the trauma department or call an ambulance for help, be sure to report all medications you have taken.

Treatment of nasal fractures

If there is no displacement of the fragments, then the doctor simply treats the abrasion or wound on the skin, excises the damaged tissue, and applies sutures. The victim is injected with antitetanus serum. Healing usually occurs quickly since the nasal area has a good blood supply. If there is a bias, it must be eliminated. The doctor returns the fragments to their place. This manipulation is called repositioning of nasal fragments:

• It is best to reduce the fragments on the 1st day after the injury, while there is no severe swelling. The maximum period is 3 weeks. If more time has passed since the fracture, then the nasal deformity must be corrected through surgery. If the victim is diagnosed with a concussion, then the reduction is postponed until 5-6 days.
• Reduction is carried out in a lying or sitting position.
• Before the procedure begins, local anesthesia with novocaine or another drug is performed.
• If there is a lateral displacement, the doctor eliminates it by applying pressure with his fingers.
• If there is a displacement in the anteroposterior direction, then the doctor inserts a special metal instrument into the patient’s nose - an elevator - and works it like a lever, returning the fragments to their place.
• After reduction, gauze swabs soaked in an antibiotic solution are inserted into one or both nostrils to prevent displacement of the fragments. Sometimes they are impregnated with paraffin for better fixation. The patient wears them for 4-7 days, changing them every 2-4 days. Special splints that are placed on the outside of the nose can also be used. They are worn for 7-12 days.

With multiple fractures of the nose and its significant deformation during reposition, it is not possible to completely restore its shape. In this case, after 5-6 months, plastic surgery is performed, during which the surgeon corrects the shape of the nose and nasal septum. After this, a special splint or plaster cast is applied to the nose, which must be worn for 10-14 days. Medicines that can be prescribed by a doctor for a broken nose:

*Here and below, the information is presented for informational purposes only. Treatment must be prescribed by a medical specialist. Self-medication is unacceptable.

Conservative treatment

It is imperative to consult a doctor if pain and swelling do not go away within 3 days, the nose is clearly deformed, nasal breathing is not restored, body temperature rises, and nosebleeds recur.

Medicines prescribed by a doctor for a broken nose:

• To eliminate pain - “Ketorol”, “Analgin”;
• Sedatives designed to relieve stress after injury and normalize sleep - “Fenozipam”, “Valocormid” for adults, “Tenoten”, “Phenibut” for children;
• General and local antibiotic therapy to prevent infection, suppuration and tissue rejection. Solutions and ointments are used locally, and tablets and injections are used systemically. Typically, broad-spectrum drugs are chosen from the group of fluoroquinolones, latest generation cephalosporins, and macrolides;
• Hemostatic drugs to prevent recurrent nosebleeds - “Ditsinon”, “Vikasol”;
• Strictly dosed and periodically drops that constrict blood vessels - “Tizin”, “Nazivin”, “Xylometazoline”;
• Ointments for eliminating hematomas - “Troxevasin”, “Rescuer”, “Bodyaga forte”;
• Vitamins and minerals for bone regeneration;
• Tetanus vaccination.

Use of medications

Doctors also use medications for nasal fractures in children. They are needed to achieve several goals.

They are reflected in the table.

Physiotherapy

Physiotherapy shortens recovery time. It is effective and safe, does not cause such effects, addiction or allergies.

For a fracture of the nasal bones, the course of physiotherapeutic treatment is selected individually.

1. UHF therapy has anti-inflammatory, analgesic, regenerating, and immunostimulating effects.
2. Infrared rays have an analgesic, bactericidal, metabolic effect, improve blood flow, nourish and restore tissue.
3. Electrophoresis triggers regeneration processes and transports drug molecules through the skin to the lesion.
4. Microwave therapy has a vasodilating effect, accelerates blood circulation, and normalizes nutrition and metabolism.

Surgical treatment

If a nasal fracture occurs without bone displacement, treat the wound and stop the bleeding. During the operation, all viable tissue is preserved, only areas of necrosis are removed. Since the face has a good blood supply, wounds heal quickly and without complications.

Fracture of the nasal bones: scheme of reduction with an instrument and finger pressure

If a displaced fracture of the nasal bones occurs, reposition is performed - realignment of the nasal bones, and then their external fixation. Local anesthesia is administered - infiltration or application. To do this, the nasal mucosa is lubricated with Lidocaine or an injection is given. Using a Volkov elevator, the sunken part of the bone is lifted and fixed with gauze, silicone swabs or turundas soaked in molten paraffin. Paraffin swabs are left in the nose until the bone fragments heal completely. To prevent suppuration of the tampon and infection of the wound, patients are prescribed antibiotics.

If a nasal injury has led to severe deformation and a fracture of the nasal septum, rhinoseptoplasty is performed - an operation during which the nasal septum is restored and a cosmetic defect is eliminated.

Septoplasty is a surgical procedure during which doctors correct and correct a deviated nasal septum. Performs small submucosal resection using 2 main methods: classical and endoscopic. The latter type is more gentle, since tissue excision occurs inside the nose, which avoids traces of surgery. Under intubation anesthesia, the nasal septum is resected and its position is changed. Then sutures are placed on the mucous membrane and other layers, hemostatic tampons are installed and a plaster bandage is applied. The duration of the operation is on average 40 minutes.

It is possible to perform septoplasty under local anesthesia using a laser. The laser beam has an antiseptic effect, due to which the risk of wound infection during surgery approaches zero. After such an operation, there are usually no complications, rehabilitation of patients is easier and faster, there is no need to use tight turundas or tampons. The operation is performed on an outpatient basis for 30 minutes.

When is a broken nose an emergency?

Every nasal fracture (even if it is not a fracture, but a bruise) should be checked by a doctor to rule out serious complications.

But here are some cases in which seeking help should not be delayed:

1. You cannot control the bleeding.
2. You find it difficult to breathe.
3. Other serious injuries are also suspected - especially injuries to the spine or neck.
4. A significant amount of clear fluid flows from the nose.
5. Large blood clots are visible.
6. The tissues of the nose turn black.

What signs may indicate a traumatic brain injury?

• Loss of consciousness at the time of injury (knockout)
• Short-term memory loss (the traumatized person repeatedly repeats his questions)
• It is impossible to wake a traumatized person from sleep
• Confusion
• Vomit
• Dizziness
• Very high blood pressure
• Very slow heart rate

Types of nasal fracture

There are several types of nasal bone fractures.

Closed fracture of the nasal bones without displacement. A person may mistake such a case for a bruise, since there is no deformation of the organ. In order to identify this type of fracture, the doctor must use an x-ray. Visual signs include swelling and bruising.

Closed fracture of the nasal bones with displacement. In this case, the suture that connects the nasal bone to the forehead area diverges, as a result of which the plate holding the nose and forehead moves. This problem can be diagnosed without using special equipment.

The displacement can be seen, since the destroyed side will be larger than the healthy one. You can feel it by grasping the damaged area of ​​the face with your thumb and forefinger. This will make it possible to feel the mobility of the nasal wall.

Open fracture of the nose with displacement. The characteristics of the symptoms are similar to the diagnosis described above, but are accompanied by heavy bleeding from an open wound.

Fracture of the nasal septum. It occurs less frequently than other cases, because the cartilaginous septum is very flexible and can withstand strong pressure; if the bone changes, the cartilage may also be subject to deformation, accompanied by the occurrence of a hematoma. Once damaged, the septum will constantly change its position even with minor impacts.

How is a broken nose treated?

Many fractures only need time and rest to heal safely. During this period (about a month and a half), intense exercise should be avoided, but light activity is not contraindicated.

Mainly, this recommendation is given to minimize the risk of re-injury to a “fresh” nose.

But even if you don’t go into the ring every weekend, take care of the septum until it is completely healed - carefully monitor door frames, protruding thresholds and other traumatic objects.

When does bone need to be restored?

This is necessary if there is a physical deformity or fracture that interferes with breathing.

There are several options for bone restoration, the choice of which depends on the specific situation.

Sometimes it is enough to straighten the nose (under local anesthesia in the traumatologist's office) and apply a plaster cast for about a week.

How to identify a broken nose?

How do you know if there is a fracture or not?

Trauma specialists identify the following symptoms of a nasal fracture:

• Strong, sharp painful sensations;
• Nose bleed;
• Swelling localized in the eye area, cheekbones;
• Bruising, subcutaneous hemorrhages;
• Deformation;
• Respiratory dysfunction;
• Intense lacrimation.

The listed clinical manifestations indicate that the nose is broken and require immediate assistance to the victim! Symptoms of a broken nose may vary slightly, depending on the type and location of the injury. If we are talking about an open type of injury, then there is a wound surface in which bone fragments are visible.

In this case, there is a high risk of infectious complications, as evidenced by such alarming clinical symptoms as redness of the skin, increased body temperature, fever and softening of tissue structures. A closed nasal fracture without displacement is characterized by preservation of shape. Damage can be determined by taking into account the following signs of a nasal fracture - swelling, hematoma formation, minor subcutaneous hemorrhages, ruptures of the mucous membrane, a feeling of pain and discomfort.

A characteristic sign of open/closed injury is bleeding. If the respiratory organ is broken, the bleeding is very profuse and intense. Damage with displacement of fragments is accompanied by deformation. This injury is indicated by curvature, shift of the septum, or change in the shape of the respiratory organ.

It is important to learn to identify a fracture from bruises and unpleasant symptoms that occur with other types of injury (for example, what signs appear if you simply break an organ, and not break it). This can be done by understanding the features of the clinical picture.

If the nose is injured, but not broken, then the swelling is localized only at the edges of the damaged organ, pain is present, but quite tolerable (if the integrity of the bone is broken, the pain is very strong, the likelihood of falling into a state of shock is high). Bleeding is also mild and is stopped using compresses and vasoconstrictor drops.

In general, the signs of bruises and fractures are quite similar, however, a broken organ has a more pronounced clinical picture, and only with a fracture can bone fragments be displaced!

What is the danger?

After a nasal fracture, a person needs competent, comprehensive therapy followed by rehabilitation. Otherwise, the following consequences of a broken nose are possible:

• Deviated septum;
• Sinusitis;
• Chronic rhinitis;
• Attachment of infectious processes;
• Impaired olfactory function;
• Neuritis;
• Recurrent nosebleeds;
• Hyposmia;
• Anosmia.

Infection is considered one of the most dangerous complications, significantly complicating and delaying the healing of the damaged organ. If the bone tissue of the skull and meninges were injured, then there is a high probability of developing meningitis. The consequences can be the most dire - even death! With severe hemorrhage in the area of ​​the eyeball, visual impairment and even complete blindness are possible.

With timely provision of competent medical care, the victim can be cured, preventing the development of adverse consequences!

What to do if your nose is broken?

First aid for a broken nose is aimed at relieving pain and relieving swelling. For these purposes, it is recommended to make a cold compress or apply a heating pad with ice to the injured area. It is also necessary to take measures aimed at stopping bleeding. The basic rule is to sit or stand straight, tilt your head as far back as possible and close your nostrils. Then swabs treated with hydrogen peroxide should be placed in the nostrils.

In case of open damage, the wound surface should be treated with antiseptics to avoid infection. In case of severe pain, give the victim (if it is an adult) a painkiller tablet to reduce the risks of possible painful shock. After the initial actions have been carried out, the victim must be taken to the trauma department of the clinic, where he will be provided with professional medical care and adequate therapy will be prescribed! Under no circumstances should you try to straighten damaged bones yourself - such actions can cause serious harm to the patient’s health and provoke a number of complications!

How to treat a broken nose?

Treatment of a nasal fracture involves repositioning to restore the correct position of the bone fragments. Correction and straightening are carried out under local anesthesia. Depending on how severe the injury is, the operation can be performed manually or using a special tool - an elevator, which allows you to lift the sunken area of ​​the bone. In more severe clinical cases, surgery—rhinoplasty—can help correct the situation.

It is possible to restore the shape of the respiratory organ surgically only after the swelling has been eliminated, 10–14 days after the injury!

Further restoration of the nose is conservative. Tampons treated with antibiotic drugs are inserted into the patient's nostrils, and sometimes a fixing bandage is applied, which should be worn for 2 weeks.

What are the signs of a deviated septum?

The very first and most noticeable symptom is difficulty breathing. Other signs may include the following:

• Nasal congestion and swelling of mucous membranes
• Nosebleeds
• Frequent infections - sinusitis, sinusitis
• Postnasal drip syndrome (when nasal discharge drips down the back of the throat and causes a cough)
• Snore
• Sleep problems
• Apnea

Signs of a deviated septum may include frequent ear infections, fatigue, dry lips and tongue after waking up (due to the fact that a person breathes only through the mouth).

As our cartilage ages, minor curvatures (after injury or congenital) can become worse with age.

And if congestion is aggravated by allergic rhinitis, excess weight or chronic sinusitis, then unpleasant symptoms may intensify.

Symptoms of a nasal fracture

In addition to the fact that some changes are visually noticeable during a fracture, characteristic symptoms are observed:

• pain in the nose area, and not only in the impact zone;
• redness and swelling at the site of injury;
• crepitation of debris;
• accumulation of air in the subcutaneous tissue under the eye, which can spread to other areas;
• local increase in temperature;
• bleeding during injury.

If the damage to bones and tissues is severe, bleeding may not stop for a long time, which threatens blood loss. Therefore, it is important that first aid for a broken nose is provided in a timely manner. However, if the injury is severe, bleeding may recur at regular intervals.

Softening of the tissue is considered a dangerous symptom, as this indicates the onset of an abscess. In damaged tissues, a cavity sometimes forms in which pus begins to accumulate. It can come out on its own through the nose. If purulent masses break through into the nose and an infection develops, the purulent process in the fracture zone leads to a brain abscess. This can be prevented by opening the abscess and removing it.

Sometimes infection penetrates into the mucous membrane, but such a symptom is observed very rarely. Infection can occur in a person with active blood flow in the nasal area or if a lot of bacteria have accumulated in the secretory secretions.

As a result of the blow, not only a fracture may occur, but also the nasal septum may swell. The tumor is located directly under the mucosa and requires surgical intervention. This makes it much more difficult to take a breath. If the tumor is not removed, the cartilage tissue will begin to deteriorate.

The victim may partially or completely lose the ability to smell. This symptom often develops as a result of a consequence of injury such as synechia, when the connective tissue, bone/cartilage fusion occurs, and the opposite walls of the mucosa are connected. Subsequently, this causes a narrowing of the nasal passage, leading to migraines and asthma attacks.

The first signs of a nasal fracture will help you understand that just such an injury has occurred:

• pronounced pain syndrome;
• state of shock;
• most often with this injury there is heavy bleeding;
• a mucous substance is released from the holes;
• external deformation of the injured area (bridge of the nose);
• severe hematomas;
• sometimes the fracture is accompanied by difficulty breathing;
• during palpation the pain becomes much more intense.

On the left there is a fracture, a visual curvature of the nasal septum is visible.
If the injury is more severe, then after a broken nose more serious signs appear:

• lack of reaction of the eye pupil;
• confusion or fainting;
• difficulty breathing;
• blurred vision;
• heavy bleeding that is very difficult to stop;
• deterioration of speech and thinking memory;
• large and bright hematomas.

These signs confirm that the nose is broken quite seriously and the victim needs immediate hospitalization and special medical care.

Difficulty breathing, bleeding and pain are symptoms of a broken nose.

Before starting treatment for a nasal fracture, it is necessary to accurately determine the presence of injury and its symptoms. Of course, this is quite simple to do, since this often causes changes in the shape of this part of the body and other characteristic signs of a septal fracture. So, what symptoms characterize the presence of a fracture of the nasal bones in children and adults:

• bleeding from the nose. For a long time, severe bleeding may occur from the nose, which will be very difficult to stop;
• pain in the area of ​​injury;
• deformation of the back of the nose;
• difficulty breathing through the nose;
• presence of bruises.

As for cases with displacement, determining the presence of injury will not be difficult, since all the evidence will be “available”. The most important symptom here is changes in the shape of the nose and bridge of the nose. After this, it may become crooked and curved. A displaced fracture can lead to undesirable consequences.

Why does a deviated septum lead to unpleasant symptoms?

Our nose is “trained” to get rid of everything unnecessary. If an object touches the sensitive inner walls, mucus production or sneezing is provoked.

Everything is in order, if such an object turns out to be fluff, we quickly get rid of it.

But if the walls of the nose themselves come into contact, then the irritation from the contact becomes constant - as does the production of mucus with subsequent swelling.

Mucus, swelling, irritation - all this leads to difficulty breathing, disruption of healthy outflow during respiratory infections and other symptoms.

Signs of a nasal fracture

A closed, non-displaced nasal fracture can easily be confused with a severe bruise, so if you receive an injury you should be examined at an emergency room.
What are the symptoms of a broken nose?

• the victim feels pain at the moment of impact;
• nosebleeds begin;
• the nose swells, a visually noticeable deformation is possible;
• a large amount of mucus flows from the nose;
• the area of ​​edema depends on the nature of the injury, in severe cases it can spread from the eyes to the lips;
• the skin around the eyes darkens, a hematoma or bruise may form;
• breathing is impaired, due to the curvature of the nasal septum, in some cases the victim can only breathe through the mouth;
• touching the fracture area causes severe pain.

This type of injury often occurs in children who cannot yet adequately assess risk and often fall or hit themselves as a result of thoughtless actions. In a child, a broken nose is accompanied by exactly the same symptoms as in an adult, only the child still cries and screams loudly. What can you do if your nose is broken?

1. Apply an ice compress to the bridge of your nose. In winter you can use snow or ice, in summer you can use improvised products from the refrigerator. This could be a piece of frozen meat or a bottle of ice water. Edible ice cubes poured into a bag will also work. The main rule of an ice compress is that you should not hold it for more than 15 minutes to prevent hypothermia. After a break of 5-10 minutes, you can reapply the compress. Ice very quickly numbs the nerve endings and is an excellent pain reliever. Exposure to cold causes blood vessels to constrict, which helps stop bleeding. An ice compress reduces swelling and helps prevent extensive hemorrhage. When using the compress, you do not need to tilt your head back so that blood does not flow into the esophagus. There is no need to plug your nose with cotton wool or other objects. If bleeding develops above the nostrils, this will not help.
2. To relieve pain, it is permissible to take any non-narcotic painkiller; the name of the drug and dose must be reported to the traumatologist. Children require a lower dosage than adults; in the instructions for each specific drug you can find the maximum permitted average daily dose for both adults and children. This figure cannot be exceeded.

Repositioning the nasal bones on your own is strictly prohibited. As a result of unskilled fracture reduction, the victim may experience chronic breathing problems.

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I had a broken nose. How can you tell if your nasal septum is deviated?

Contact an ENT specialist - he can diagnose the curvature quite easily with the help of special tools.

Modern medical centers use thin nasal endoscopes with a video camera for these purposes (and you can take a look at your inner world yourself!)

MRI and CT scans can also be used to diagnose sinus conditions.

If the bridge of the nose is crooked after an injury, is the septum also deviated?

Curvature in this case is very likely, but its degree can only be determined by a doctor, looking “from the inside.”

Noses that are perfectly straight in appearance can cause a lot of inconvenience to their owners, but noses that are “beaten by life” can “behave” well for years.

Pay attention first to the symptoms.

Signs of a nasal fracture

A closed, non-displaced nasal fracture can easily be confused with a severe bruise, so if you receive an injury you should be examined at an emergency room.
What are the symptoms of a broken nose?

• the victim feels pain at the moment of impact;
• nosebleeds begin;
• the nose swells, a visually noticeable deformation is possible;
• a large amount of mucus flows from the nose;
• the area of ​​edema depends on the nature of the injury, in severe cases it can spread from the eyes to the lips;
• the skin around the eyes darkens, a hematoma or bruise may form;
• breathing is impaired, due to the curvature of the nasal septum, in some cases the victim can only breathe through the mouth;
• touching the fracture area causes severe pain.

This type of injury often occurs in children who cannot yet adequately assess risk and often fall or hit themselves as a result of thoughtless actions. In a child, a broken nose is accompanied by exactly the same symptoms as in an adult, only the child still cries and screams loudly. What can you do if your nose is broken?

1. Apply an ice compress to the bridge of your nose. In winter you can use snow or ice, in summer you can use improvised products from the refrigerator. This could be a piece of frozen meat or a bottle of ice water. Edible ice cubes poured into a bag will also work. The main rule of an ice compress is that you should not hold it for more than 15 minutes to prevent hypothermia. After a break of 5-10 minutes, you can reapply the compress. Ice very quickly numbs the nerve endings and is an excellent pain reliever. Exposure to cold causes blood vessels to constrict, which helps stop bleeding. An ice compress reduces swelling and helps prevent extensive hemorrhage. When using the compress, you do not need to tilt your head back so that blood does not flow into the esophagus. There is no need to plug your nose with cotton wool or other objects. If bleeding develops above the nostrils, this will not help.
2. To relieve pain, it is permissible to take any non-narcotic painkiller; the name of the drug and dose must be reported to the traumatologist. Children require a lower dosage than adults; in the instructions for each specific drug you can find the maximum permitted average daily dose for both adults and children. This figure cannot be exceeded.

Repositioning the nasal bones on your own is strictly prohibited. As a result of unskilled fracture reduction, the victim may experience chronic breathing problems.

How is a deviated septum treated?

We would like to note: not all cases of curvature require treatment, even those that occur after a nasal fracture.

However, if normal breathing is disrupted, chronic infections occur, or sleep apnea occurs, doctors may recommend surgery to correct it. It is called septoplasty and is considered quite simple.

How is septoplasty performed?

During this operation, the doctor surgically removes part of the cartilage of the nasal septum. And moves it so that the airways on both sides are open.

It is possible that a slight curvature will remain after surgery, but it is unlikely to cause any discomfort.

Septoplasty is generally well tolerated, but like any surgery, it carries some risks. This is why doctors do not prescribe septoplasty without indications, based only on the “feeling of beauty.”

Modern medical centers use minimally invasive methods of septoplasty - using a radioknife or laser. They are considered less traumatic, since these instruments not only “cut”, but also “baked” blood vessels and capillaries.

Recovery after surgery occurs gradually over several days and weeks (longer with classical surgery, faster with radio or laser surgery). However, it may take 6 to 12 months for the tissue to heal completely.

Symptoms of a nasal fracture

The first signs of a nasal fracture will help you understand that just such an injury has occurred:

• pronounced pain syndrome;
• state of shock;
• most often with this injury there is heavy bleeding;
• a mucous substance is released from the holes;
• external deformation of the injured area (bridge of the nose);
• severe hematomas;
• sometimes the fracture is accompanied by difficulty breathing;
• during palpation the pain becomes much more intense.

On the left there is a fracture, a visual curvature of the nasal septum is visible.
If the injury is more severe, then after a broken nose more serious signs appear:

• lack of reaction of the eye pupil;
• confusion or fainting;
• difficulty breathing;
• blurred vision;
• heavy bleeding that is very difficult to stop;
• deterioration of speech and thinking memory;
• large and bright hematomas.

These signs confirm that the nose is broken quite seriously and the victim needs immediate hospitalization and special medical care.

• Absolute signs of a fracture

Emergency first aid for a fractured nasal bone

A fracture of the nasal bones is one of the most popular injuries in our country, so to speak.

Since the nose is a strongly protruding part of the face, under certain circumstances and events this fact of human anatomy becomes its primary problem. According to statistics, a little less than half of all types of head injuries are fractures of the nasal bones. The second place, apparently, is occupied by eye injury. The third, apparently, is the forehead. There is only one reason for a fracture of the nasal bones - this is the direct impact of hostile forces on it during:

• a friendly match in football, hockey, boxing, rugby, etc.
• heavy objects falling on the nose: fists, bats, flames, etc.
• falling from height onto face
• direct collision with a door, wall and other supporting structures
• direct contact with the hooves of fresh livestock
• inept handling of all types of transport, including personal aircraft, hang gliders, boats and yachts.

All these, sometimes very funny in our opinion, reasons are listed on many sites. We decided to keep up with everyone else in originality and add a couple more folk wisdom about the causes of nasal injuries:

• Don't poke your nose into things that aren't yours.
• Keep your head high without raising your nose.
• Don't put your nose in the air, or you'll fall.
• They call you, they call you, they call you, and then they poke you in the nose.
• They tore off the bear's nose so he wouldn't sniff dichlorvos.
• Well-fed, drunk, black eyes and tobacco on his nose.
• If you're angry, bite your nose.
• Even though the fire is raging in your chest, don’t let the smoke out of your nose.
• Take care of your nose in the extreme cold.

What does a broken nose look like?

By what signs can one suspect a fracture of the nasal bones?

First, we need to clarify the classification of types of nasal fractures. They, like fractures of other bones of the human skeleton, can be divided into two large groups:

• Closed fracture
• Open fracture

If you see and can even feel a piece of the nasal bone protruding from the wound, then you have an open fracture.
If the deformed nose does not have such features, consider that you have a closed fracture.

This classification, of course, is far from scientific and should, in theory, have a lot of reservations. We will focus on it, since our readers do not have a medical education, and the level of pre-medical training does not require deep knowledge in medicine. You should also pay attention to the fact that perhaps the victim has displacement of bone fragments or cartilage.

In practice, a fracture of the nasal bones can be suspected based on the following signs:

• nasal deformity. The nose may be flattened and turned to the side. This is an absolute sign of a fracture.
• a sensation of crunching (crepitus) under the fingers at the fracture site. This is the sound made by pieces of broken bone. An inexperienced person may mistake the sound of friction of bone fragments and the sound of moving air bubbles (subcutaneous emphysema) under the skin of the nose. This will not be a fatal mistake when choosing a method of first aid. There is no accumulation of air under the skin of the nose without a fracture. Both crepitus and subcutaneous emphysema can be considered absolute signs of a fracture of the spit bones (sometimes other bones of the facial skull).
• profuse nosebleeds. Bleeding from the nose can also occur with a bruise, but with a fracture it is usually much more intense. It is worth paying attention to where the blood flows. Bleeding can be external, that is, blood simply flows from the nose onto the face. There may also be bleeding along the back wall of the throat. Such bleeding is not visible. This is his main danger. A person either begins to swallow blood, which can subsequently lead to abdominal pain and vomiting, or, while in an unconscious state, can suffocate or get severe pneumonia due to blood flowing into the trachea and lungs.
• nasal breathing disorder. A bruised nose is also accompanied by a feeling of nasal congestion due to swelling of the soft tissues. With a fracture, disruption of normal nasal breathing occurs not only due to swelling of the nasal mucosa, but also due to displacement of cartilage and bones. Such congestion does not go away quickly and completely, unlike congestion from a bruise.
• by intense pain at the fracture site. The human face is a very pain-sensitive area of ​​the body. However, the pain from a bruise will not be as intense and lasting as from a fracture. You just need to remember that in a state of even slight alcohol intoxication, the sensation of pain is significantly dulled. In a sober state, a person describes very severe pain at the time of injury and after it. Even a short-term loss of consciousness and a significant drop in blood pressure is possible precisely because of the sudden severe pain.
• bruising, swelling of the soft tissues of the nose, cheekbones, eyelids will be observed by you with any type of injury to the nose.
• not often, but there is a situation when, after an injury to the nose, not only blood begins to flow from it, but also some kind of yellowish transparent liquid. It is very likely that this is not snot (sorry for being blunt), but cerebrospinal fluid. This indicates damage to the bones inside the skull itself or a fracture of its base. This is a very dangerous scenario! Such a victim must be transported to the hospital as soon as possible with the utmost care.
• Despite the fact that the nasal bones are very thin, a certain force must be applied to break them. This force is enough that in addition to a fracture of the nasal bones, a person also receives a concussion. This will be indicated by loss of consciousness, loss of memory about immediate events, headache, dizziness, nausea, vomiting. For this reason, along with a diagnosis indicating a nasal injury, doctors almost always write that the patient has a concussion. Such patients should definitely be consulted by a neurologist, possibly a neurosurgeon.

Help with a broken nasal bone:

If the person is conscious and able to communicate with you:

• position him so that his torso and head are tilted slightly forward. This will be a good prevention of blood flow into the esophagus and trachea.
• if there is a wound on the surface of the face, treat it with an alcohol-containing liquid or simply rinse with clean water. Cover the surface of the wound with a clean cloth. Do not remove anything from it or set bone fragments.
• if there is external bleeding from the nostrils, try to pack them as deeply as possible with gauze or thin material. The fabric must first be moistened with water or lubricated with baby cream or vegetable oil. The fluff of the material of a homemade tampon will not dry to the mucous membrane and will not provoke the resumption of bleeding after its removal. If you want to make a cotton wool tampon, you need to wrap it before placing it in your nose. Cotton itself sticks very strongly to the mucous membrane and is especially difficult to remove from the surface of the wound. It is necessary to place a tampon in a deformed nose very carefully so as not to displace the fragments and not further damage the soft tissues of the nose. It is absolutely forbidden to try to restore the previous shape of your nose on your own!
• Regardless of whether there is bleeding or not, it is necessary to apply cold to the bridge of the nose. Any product from the freezer, snow, ice, or a bottle of water can be used. Do not forget that there should be a layer of fabric between the skin and the source of cold.
• Seek medical help as soon as possible

If the person is unconscious and unable to communicate with you:

• secure your neck as carefully as possible
• gently place the victim on his side
• call the ambulance team

Do not forget that fractures with displacement of bone fragments and cartilage must begin to be treated on the very first day. Delayed seeking of help will make the intervention of specialists quite difficult and more painful.

Untreated fractures will lead to a lot of complications in the near future:

• Early complications include all kinds of inflammatory processes. “Harmful” microorganisms instantly land on the injured mucous membrane and skin.
• deformed bones and cartilage subsequently disrupt normal nasal breathing. As a result, a person begins to suffer from a lack of oxygen, which in turn leads to insomnia, headaches, decreased memory and attention. In addition, disruption of normal air circulation in the nasal cavities and the outflow of mucus from the nose leads to the development of chronic inflammatory processes: sinusitis, sinusitis, otitis media, etc.

Therapeutic measures

It is necessary to seek help from a doctor as soon as possible to avoid complications. Treatment for a broken nose will depend on the severity of the injury. It is determined by the surgeon. In case of severe bleeding, treatment is aimed primarily at stopping it. The doctor performs tamponade of the nasal passages with gauze swabs soaked in a special solution. If there is an open wound, it is cleaned and treated with an antiseptic.

If no more than 10 days have passed since the injury, the surgeon may try to manually reposition the bones under local anesthesia. To do this, using a Volkov elevator, bone fragments are lifted and fixed using paraffin tampons or splinting. You need to wear tampons for a week, and 2 weeks with splints. If only cartilage is broken, then reduction is not performed. If there is a hematoma in the nasal septum, drainage is performed to prevent infection.

Conservative treatment

If the fracture is simple, after first aid is provided, the victim is sent home. Conservative treatment is prescribed. Drug therapy:

• painkillers - Analgin, Ketorol, Ibuprofen, Dexalgin;
• sedatives to relieve stress and normalize sleep - Phenazepam, Valocormid, Tenoten, Phenibut;
• antibacterial drugs (local and general) with a wide spectrum of action - these are macrolides, fluoroquinolones, cephalosporins;
• hemostatic drugs - Vikasol, Dicynon;
• vasoconstrictor drops - Xylometazoline, Nazivin, Tizin;
• ointments for resorption of hematomas - Troxevasin, Badyaga, Rescuer;
• vitamin and mineral complexes;
• Tetanus vaccine.

Physiotherapy is prescribed individually:

1. Electrophoresis helps deliver medications to the injured area. If there is constant congestion, a physiotherapy with herbal solutions is prescribed; if the bones heal slowly, a physiotherapy with mineral solutions is prescribed.
2. UHF therapy has an anti-inflammatory effect, relieves pain, and starts regeneration processes.
3. Infrared rays have an analgesic, antibacterial, and metabolic effect. Improve tissue nutrition and enhance microcirculation.
4. Microwave therapy improves blood circulation, dilates blood vessels, normalizes metabolism and nutrition.

Surgery

If the injury is more than 3 weeks old, surgery is required to restore nasal breathing and straighten the nose.

Septoplasty is the correction of a deviated nasal septum. Surgery can be performed in 3 ways: classical, endoscopic, laser.

Classical and endoscopic septoplasty is performed under general anesthesia with tracheal intubation. Submucosal resection of cartilage tissue is performed, their position is changed to the correct one, and sutures are applied. Thick hemostatic tampons are placed in each nasal passage. The intervention lasts approximately 40 minutes.

Laser septoplasty is performed under local anesthesia. Infection with such an intervention is almost impossible, because the laser beam has an antiseptic effect. The use of tight turundas is not required, the postoperative period is easier and faster. The procedure is performed on an outpatient basis and lasts about 30 minutes.

The next stage is restoration of the aesthetic appearance of the external nose. For this purpose rhinoplasty is performed. The operation makes it possible not only to remove the consequences of the fracture, but also to change the shape of the bridge of the nose, the tip of the nose. The cosmetic defect is removed using silicone or cartilage implantation. Conducted with open and closed access.

The necessary incisions are made, the skin is separated from the cartilage and periosteum. Using instruments, the shape of cartilage and bones is changed, and implants are placed. Then all the tissues are sutured in layers and a plaster cast is applied. You need to wear it for 2 weeks. You need to stay in the hospital for 10–14 days.

Possible complications of a nasal fracture

In most cases, the consequences of a nasal fracture are more difficult to eliminate than the fracture itself. Failure to see a doctor in a timely manner or self-medication can lead to the development of serious pathologies:

1. Hematoma on the nasal septum. When bleeding occurs, blood often accumulates inside the nasal cavity, which can lead to the development of a hematoma. If excess fluid is not pumped out in a timely manner, an abscess may form, inside which pus appears. This condition can lead to the development of sepsis or blood poisoning.
2. Chronic rhinitis. After a broken nose, the victim suffers from constant stuffiness. The patient has difficulty breathing, and ordinary vasoconstrictor drops do not help. In this case, additional examination is required for damage or displacement of the mucous membranes and nasal septum.
3. Apnea (stopping breathing during sleep). After a broken nose, breathing problems may occur during sleep, which can even lead to death. The reason for this is often scars formed inside the nasal passages or pathological growth of connective tissue.
4. Sinusitis. Due to constant congestion and swelling inside the nasal passages, the outflow of mucus is disrupted. As a result, the secretion accumulates in the sinuses, causing inflammation.
5. Changing shape. If, after a fracture, the bones and cartilage were folded incorrectly, a hump may form on the bridge of the nose or a deviated septum.

If the nose is injured, neighboring organs may be affected. Complications of a fracture can also include:

• displacement of the eyeball;
• damage to the lining of the brain by fragments of bone tissue;
• neuritis of the facial nerves;
• impaired secretion of the mucous membranes of the nasopharynx;
• dislocation or subluxation of the jaw.

To avoid serious consequences if you suspect a broken nose, you should immediately consult a doctor. Timely and correct treatment will minimize the development of complications.