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"A complete history and clinical assessment will be done by the attending surgeon to assess if there are any nasal or facial fractures (see illustration below)," says Dr Terence Goh, Consultant, Department of Plastic, Reconstructive & Aesthetic Surgery, Singapore General Hospital (SGH), a member of the SingHealth group.

Nasal Bone Fracture
A basic X-ray will then be done to confirm the presence of the nasal fracture. A CT scan may be ordered to provide more information regarding the nasal septum and if there are any other facial fractures (refer to scan below).

CT scan of nose

Not all broken noses will require surgery. Surgery may not be required if there are only minor fractures with no misalignment. Painkillers and antibiotics may be all that is required.

In some instances, if the fracture is simple, a close reduction can be done under local anaesthesia when the nose is numb and the doctor can manually realign it. In the first two weeks after a minor broken nose, the easiest way to fix the shape is to break the healing tissue along the fracture lines and set the broken fragments back into the correct position.

Manipulation and reduction (M&R) of the nasal bone and septum can also be done under general anaesthesia for more severe cases. In cases where there is injury to the nasal septum, a septorhinoplasty will be done. Surgery if usually performed a few days after the injury when the swelling starts to resolve and before 14 days when the bones start to heal.

How to prepare for a post-trauma surgery of the face?

In the early period after a nasal fracture (less than two weeks), a minor procedure called a manipulation and reduction (M&R) of nasal fracture can be done to re-align the nasal bones and the central nasal septum. This is a closed procedure where there will be no incisions made and the nasal bones and septum are manipulated back to its original location and held in place by nasal packing and splints.

It may take one to two weeks for the swelling to subside. The success of the reduction of the nasal fracture will depend on the severity of the injury and if the bones are stable enough to heal. Nonetheless, an M&R should always be considered as it may save you a major reconstructive rhinoplasty in the future.

There are different types of broken nose injuries and symptoms. Click the link to find out what they are. 

Ref: N18