Nasal Fracture or Contusion

Injuries to the nose are one of the most common facial afflictions. These injuries may include fractures of the nasal bones, or trauma to the soft tissue (contusion). The upper one-third of the nose is bone, while the lower two-thirds is composed of cartilage. It is a fracture to the upper bony section of the nose that defines nasal fracture. Nasal injuries may also have associated injury to the orbit (bony cavity containing the eye), sinuses, or nasal septum (the partition that divides the nose and forms the nostrils).


Deformity of the nose.

Swelling and bruising to the nose.

Crepitation, or abnormal motion of the nasal bones.

Periorbital ecchymosis (black eyes).

Subconjunctival hemorrhage (blood in the whites of the eye).

Lip swelling.


Evaluation will include examination for lacerations, septal swelling [which may require special treatment], and any clear nasal discharge that indicates skull fracture. Nasal x-rays will reveal a fracture and the extent of the deformity. Treatment of most simple nasal fractures is conservative. Nondisplaced nasal fractures often require a decongestant which constricts vessels to control bleeding. Oral antibiotics may also be necessary to reduce the possibility of secondary infection. Surgical repair of displaced nasal fractures is often delayed until swelling has subsided (usually 7 to 10 days later). In all cases, patients should avoid hot liquids and aspirin [as it promotes bleeding]. The use of cold compresses will reduce swelling. Pain medications (acetaminophen) may be used for mild discomfort. Any lacerations to the skin overlying the fracture site must be cleansed and sutured. Protruding nasal bones due to an overlying laceration, requires special treatment. A protracted nasal hemorrhage (nosebleed) may require nasal packing. Special consideration must be given to the child with a displaced nasal fracture. Inappropriate realignment, or failure to receive treatment, can result in abnormal growth of the nose. Follow-up with an ENT Specialist or Plastic Surgeon is recommended.

Hope this article will provide you information about nasal fracture or contusion.

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