Nasal Fractures That Need an Open Reduction and Internal Fixation

Most nasal fractures are treated with a closed reduction. The bones are moved without opening the skin. The bones are then externally fixed with a splint. Occasionally an internal splint or packing is used to help with septal injury or bleeding.

Rarely the fracture is severe enough to need an internal repair. Such fractures often are part of other facial fractures or lacerations (wounds). Internal fixation means that the broken bone fragments are held together with wire or other suture, screws and or plates. This type of surgery is more complex than a closed reduction and is often done in the operating room under general anesthesia.

An unstable open nasal fracture (with laceration)

The deformity	X Ray	X rays showing multiple bone fragments	Wires can hold the multiple fragments in place

This patient had laceration and severe nasal fracture that was too unstable for splinting alone. Stainless steel wires were used to hold the bone fragments together. We now occasionally use tiny plates and screws for the more severe nasal fractures. The smallest of the plates and screws measure 1 mm. Plates, screws and wires are more likely to be felt through the skin after healing. They are rarely seen. In most cases they can be left in after surgery although there is a risk of long term infection or loosening. Removal means opening the incision or making a new one.

Titanium plates and screws

The smallest size shown are 1 mm, which can be very valuable in severe nasal fractures.

Putting these tiny fragments together is often like working with a jigsaw puzzle with missing pieces. I sometimes feel like "all the king's men" putting "Humpty Dumpty together again." To play on these words I used some of the first very tiny plates to "repair" a robin's egg. I also "fixed" some Channel cosmetics with the newer titanium plates for some "cosmetic surgery".

Rhinoplasty Nasal Surgery Important Information

About Dr. Bermant

Find us

Multimedia Lectures

Kid's view

Other Bulletin boards

• Nasal fractures / trauma / broken nose part 1
• Nasal fractures / trauma / broken nose part 2
• Nasal fractures / trauma / broken nose part 3

More on nasal obstruction septoplasty

• Nasal obstruction
• Nasal obstruction 2
• Nasal obstruction 3
• Septal perforation
• Nasal reconstruction

Rhinoplasty Bulletin Boards

• Rhinoplasty 1
• Rhinoplasty 2
• Rhinoplasty 3
• Rhinoplasty 4
• Rhinoplasty 5
  

Nasal Fractures basic

• patient photographs
• open treatment of fractures of the nose

Rhinoplasty (nasal surgery that can correct nasal deformity

Learn about nasal reconstruction.

Rhinophyma Acne Rosacea sculpting nasal deformity.

PlasticWeb

Other Nasal Topics

• Medical Treatment of Nasal Obstruction
• Nasal Reconstruction
• Rhinophyma (Acne Rosacea)

PlasticArt

Tour of Nasal Deformity in Art

Nasal deformity, is it bothering you?

Nasal hump and drooping tip deformity

• Rubens nasal hump and drooping nasal tip (1612)
• Bouchardon's Pope Clement XII Statue (after 1730)
• Houdon's Adrian - Cyprien Statue (19th Century)
• Italian plate (1520-25)
• Thomas Gainsborough painting Mrs. M. Fitzherbert (1780)

Deformity after nasal fracture

• Rodin man with a broken nose
• Rodin Man with a Broken Nose with computer "surgery"
• Young Duke with Deformed Nose (1785)

Nasal tip loss

• Egyptian Statue New Kingdom (1539-1295 BC)
• Sphinx Nasal Loss
  • Ramses nose from mummy reconstruction
  • Kafre nose from statue reconstruction
• Roman Statue Caligula (38-40 AD)
• Ancient Statue

Home

Member of the American Society
of Plastic Surgeons, Inc.

Shop at The Surgery Store for your skin care, comfort, and recovery needs.

Hear Dr. Bermant's Multimedia Lectures in your community

Find this site useful? Tell a friend!

Search for a Book from Barnes and Noble

© 1996-2008 Michael Bermant, MD

Legal Information - Privacy Policy

This page last updated on: April 27, 2008

Member of the American Society
for Aesthetic Plastic Surgery, Inc.