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)
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| 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. |
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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".
Learn more about rhinoplasty surgery of the nose
Open Rhinoplasty - Photographic details during surgery of the
Black nose (warning graphic pictures).
Open Rhinoplasty - Pictures of dorsal and tip sculpture during
surgery (warning graphic photographs)
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Patient Pictures before and after surgery
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Rhinoplasty Experiences Discussions, Forum, and Chat
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Nasal Obstruction Septoplasty and Other Nose Discussion Groups, Forum, and Chat
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Nasal Fracture (broken nose)
