Broken Nose

Diagnosis

A fracture is caused by a blunt, hard blow to the face. It often occurs along with injuries to other parts of the nose and face.

Symptoms of a facial fracture or broken nose include:

  • Pain in the nose or surrounding area of the face
  • Swelling of the nose or surrounding area of the face
  • Bleeding from the nose (often heavy)
  • Discoloration of the nose
  • Black eyes
  • Crooked or misshapen appearance of the nose (may not appear until swelling subsides

The doctor will ask about your symptoms, how the injury occurred, and examine your nose for:

  • Irregularities in the shape
  • Movement of the bones
  • Rough sensation when your nose is moved
  • Pain or tenderness to touch

Unless there is an obvious deformity, it is often necessary to wait several days for the swelling to subside before a fracture can be diagnosed. Tests will include an x-ray of the nose to confirm the fracture and check its location and severity.

Prevention

The following factors may increase your chance of getting a nose or facial fracture:

  • Previous nose fracture or nose injury
  • Participating in sports (especially contact sports)
  • Reckless behavior during recreational activities or driving
  • Failure to wear a seatbelt

What Treatment is Needed for a Broken Nose?

Bruises around the eyes and/or a slightly crooked nose following injury usually indicate a fractured nose. If the bones are pushed over or out to one side, immediate medical attention is ideal. But once soft tissue swelling distorts the nose, waiting 48-72 hours for a doctor’s appointment may actually help the doctor in evaluating your injury as the swelling recedes. (Apply ice while waiting to see the doctor.) What’s most important is whether the nasal bones have been displaced, rather than just fractured or broken.

For markedly displaced bones, surgeons often attempt to return the nasal bones to a straighter position under local or general anesthesia. This is usually done within seven to ten days after injury, so that the bones don’t heal in a displaced position. Because so many fractures are irregular and won’t “pop” back into place, the procedure is successful only half the time. Displacement due to injury often results in compromised breathing so corrective nasal surgery, typically septorhinoplasty, may then be elected. This procedure is typically done on an outpatient basis, and patients usually plan to avoid appearing in public for about a week due to swelling and bruising.