Simple digital manipulation as a closed reduction technique for favourable nasal bone fractures

ABSTRACT

Isolated fractures of the nasal pyramid are the most common facial injuries. Accurate diagnosis and appropriate surgical intervention are key in the management of nasal fractures. While these fractures are not-life threatening and normally considered a relatively unimportant injuries, suboptimal treatment can Lead to both aesthetic and functional deformities. Reduction of favourable nasal fractures may be performed under local or general anaesthesia.62 adult patients with clinically displaced nasal fractures were enrolled in the study, of them only 52 completed the follow-up period [three months]. Working with a detailed patient history and a thorough physical examination that included rigid nasal endoscopy, the author formulated an integrated systematic approach to reduce the incidence of posttraumatic nasal deformity. The management was complete by simply moulding the nasal bones with the fingers under a brief general anaesthesia, promoting the patient comfort by not using intranasal packing. The success rate in terms of patients' satisfaction was 94% at the end of the follow up period, while the surgeon was happy with the result an average of 89% of the time. The low incidence of failure is attributed to complete nasal assessment [bony and septum] and to the use of general anaesthesia. Our results show that this simple closed reduction technique is efficient and effective in managing favourable nasal bone fractures. The patient comfort and the cost-effectiveness of the manoeuvre give additional advantages