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The most common facial fracture is a broken nose. The nose is in a prominent place in the center of the face and unprotected, which makes it vulnerable to injuries. While some nose fractures require no medical treatment, more severe injuries require immediate medical attention.

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Nasal Anatomy

The cartilage and bone beneath the skin of the nose give it its shape and size, while other interior structures help the breathing process. Two bones form the bridge of the nose and support the upper parts and the cartilage that forms the lower section. The nasal septum is a thin wall of cartilage and bone that divides the nose interior into two chambers.

cartilage bone shape nose anatomy Sakurra / Getty Images
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Nasal Fracture Causes

A broken nose is a break in the bone or cartilage over the bridge of the nose, the septum, or its sidewall. Most breaks are caused by a blunt force injury and frequently occur alongside other facial fractures. A severe blow can also cause neck injuries.

break bone septum bridge injury Tashi-Delek / Getty Images
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Symptoms

The first sign of a nasal fracture is pain. Swelling of the nose and its surrounding areas, along with bruising around the eyes is common. The nose often appears crooked or bent and when the individual touches it, they may hear a crackling or crunching sound. Nosebleeds, runny noses, and nasal passage blockages can also occur.

nasal fracture pain swelling bruising photographer / Getty Images
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Mild Fractures

In many cases of mild nose fractures, people do not realize they have a break and never seek treatment. Because the broken bones can tear the mucous membranes in the nose, nosebleeds, moderate swelling, and discomfort are common. Taking over-the-counter pain medication and applying ice packs to the area several times a day to reduce swelling is usually effective. Pain and swelling typically subside within one to two weeks. However, you should always seek medical attention if you have an injury to your nose or face or suspect a nose fracture.

mild fracture swelling discomfort nose Bigpra / Getty Images
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When to Seek Emergency Treatment

Although most nasal fractures do not require treatment — in part because unlike a limb, the area cannot be placed in a cast and is immobile by nature — more severe nose injuries can lead to serious complications. Symptoms of a severe nasal fracture include

  • Difficulty breathing
  • A puncture or cut on the skin of the nose
  • Bleeding that will not stop
  • Severe headache
  • Neck pain
  • Clear fluid persistently draining from the nose
  • Vomiting
  • Loss of consciousness
  • A twisted or crooked shape to the nose, not related to swelling
emergency treatment breathing headache pain sturti / Getty Images
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Complications

If the nose bleeds for more than 15 minutes following a broken nose, it could be a sign of a more serious issue. A small, grape-like swelling that appears on the nasal septum 24 to 72 hours after the injury may indicate a septal hematoma. This rare but serious complication can occur as a result of nasal or facial trauma. Septal hematomas must be drained quickly by a healthcare professional to prevent infection or damage to the cartilage. Abnormalities in the tissue of the nose are signs of a deviated nasal septum. Cuts or punctures on the nose could lead to a severe infection such as meningitis or a brain abscess.

nose bleeds hematoma deviated septum Feodora Chiosea / Getty Images
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Rare Complications

Some nose fractures lead to a loss of smell, called anosmia, and it may never return. Severe nose trauma can push the nasal bones into the face and cause a fracture of the thin cribiform plate at the roof of the nose. This can lead to a leakage of cerebrospinal fluid from the brain. Both of these complications are extremely rare.

anosmia smell rare complications fracture microgen / Getty Images
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Signs of Infection

Increased pain and swelling can be early signs of an infection. The area around the nose may turn red and feel warm to the touch. People with an infection will likely have a fever. The infection can develop with any wound to the exterior skin of the nose if there was a cut or puncture wound, but it can also occur inside the mouth or nose following a facial injury.

increased pain swelling complications fever Milan_Jovic / Getty Images
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Nose Fracture Diagnosis and Treatment

Physicians generally wait three to five days for the swelling to improve before treating nose fractures. Although X-rays are not generally necessary, the doctor may order a CT scan to determine the severity of the injury. Some injuries require realignment: the physician manually pushes the broken pieces of bone back into place. Surgery may be necessary if the break is severe, it hinders the ability to breathe, or the septum was damaged.

physician diagnose nose fracture treatment DjelicS / Getty Images
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First Aid

If a person's nose is bleeding, they should lean forward to prevent the blood from draining down the back of the throat. Use ice packs or cold compresses — without applying any pressure — every 10 to 15 minutes for the first two days following the injury. Elevate the head when sleeping to reduce pain and swelling. Limit activities such as contact sports for a minimum of six weeks to allow the injury to heal.

lean forward nose bleeding aid ollo / Getty Images

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Disclaimer

This site offers information designed for educational purposes only. You should not rely on any information on this site as a substitute for professional medical advice, diagnosis, treatment, or as a substitute for, professional counseling care, advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional.