ABSTRACT
PURPOSE: A radiologic examination is required in the treatment of nasal bone fracture to determine the fracture condition. Thus, there is an increasing need for radiologic classification of nasal bone fractures that can be applied to clinical practice. MATERIALS AND METHODS: Computed tomography was performed in 125 patients with nasal bone fractures to determine which axial view best showed the entire nasal view. The obtained axial view was then used as a reference for classification. The length from the top to the base of the nasal bone was divided into upper, middle, and lower levels, after which the fracture location was determined. If the fracture spanned the boundaries of these levels, it was classified as the total level. Subsequently, the fracture was subclassified based on the fracture direction and pattern and the concurrent fracture. RESULTS: Radiologic examination of patients with nasal bone fracture showed that nasal bone fracture was frequently found at the total, middle, upper, and lower levels, in that order. Nasal bone fractures at the upper level showed lower frequencies of complication and reoperation than the fractures at the other levels, whereas nasal bone fractures at the total level showed the highest frequencies of complication and reoperation. CONCLUSION: Radiologic classification can be useful for preoperative and postoperative evaluations of nasal bone fractures and can be helpful in understanding such fractures because it can efficiently predict the prognosis of a fracture.
Subject(s)
Nasal Bone/injuries , Skull Fractures/classification , Tomography, X-Ray Computed/methods , Fractures, Comminuted/classification , Fractures, Comminuted/diagnostic imaging , Humans , Maxillary Fractures/classification , Maxillary Fractures/diagnostic imaging , Nasal Bone/diagnostic imaging , Nasal Obstruction/etiology , Nasal Septum/diagnostic imaging , Nasal Septum/injuries , Nose Deformities, Acquired/etiology , Nose Diseases/etiology , Postoperative Complications , Prognosis , Radiographic Image Enhancement/methods , Reoperation , Retrospective Studies , Skull Fracture, Depressed/classification , Skull Fracture, Depressed/diagnostic imaging , Skull Fractures/diagnostic imaging , Skull Fractures/surgery , Tissue Adhesions/etiologyABSTRACT
Closed reduction is commonly conducted for the treatment of a nasal bone fracture unless a concurrent fracture or a severe nasal septum fracture is observed. As the reduction, however, is not conducted through the direct gross observation of the fracture site, it is difficult to obtain a good result from it. Accordingly, a supplementary process is required. Closed reduction with a C-arm was conducted within the period from March 2009 to January 2010 on 50 patients with nasal bone fractures, to treat these fractures or to evaluate the postoperative conditions of such. The usefulness of the C-arm was evaluated by comparing the aforementioned closed reduction with a C-arm with the closed reduction without a C-arm that was conducted on 64 patients with nasal bone fractures within the period from January 2008 to February 2009. The complication morbidity and re-operation rate were significantly lower in the patient group with closed reduction with a C-arm, and the radiologic examination also showed a significant difference. If closed reduction is conducted on patients with nasal bone fractures using a C-arm, an accurate result can be obtained by observing the fractured bone indirectly with continuous imaging during the operation, and the operation result can be immediately assessed in the operating room, thereby reducing the frequencies of complications and re-operation.