Nasal fractures

CLOSED REDUCTION NASAL FRACTURE POST-OPERATIVE INSTRUCTIONS:

Overview:
– Closed reduction of nasal fracture is the medical term for ‘setting’ the nose back into place following a broken nose that has caused displacement of the normal anatomical structure
– This procedure is time sensitive and cannot be performed more than 2 weeks following the incident
– After two weeks, the body will naturally heal the displaced bones in the abnormal position, and makes it much more difficult to realign and reshape the nasal bones.
– The procedure is performed to try to return only the external bony portion of the nose to its pre‐injury state.

What to expect:
– Closed nasal reduction is most commonly performed under a relatively short general anesthesia.
– Local anesthesia is used in the office to numb the nose prior to shifting the displaced bones back into position (internal cotton numbing pledgets may be used to further anesthetize the area)
– Pressure will be applied to the outside of the nose following the use of the anesthetic
– Occasionally the bone may need to reduced from the inside as well which may cause some additional bleeding (minimal)
– Some patients will have oozing of blood, or bloody mucus for the first few days. If the patient is having hemorrhage from the nose, we would request that you contact Dr. Dagan for further instructions. The patient is occasionally sent home with a drip pad if there is oozing prior to discharge.
– There will be a cast on the outside of the nose for approximately one week
– If asymmetries persist after closed nasal reduction, then in about 3 months we can address both external and internal deviations and asymmetries with cosmetic rhinoplasty, and/or functional septoplasty, and/or other nasal procedures.

Pain:
– The pain following a closed reduction of a nasal fracture is generally mild, and subsides during the first few days after the procedure. It is usually well-controlled by taking Tylenol, or a mild narcotic. We would request that the patient avoid NSAID pain medications, such as Motrin, ibuprofen, Advil, Aleve, or aspirin.

Activity:
– No vigorous exercise
– Sneezing with an open mouth is best/ Gentle nose blowing
– Avoid activities that would increase sweating and cause the cast to come off
– Avoid getting water on the cast as it only remains attached to the skin by a topical adhesive. With Showering, keep the head bent backwards so no water runs on or under the cast. If the cast falls off 1‐2 days prior to the one‐week postoperative visit, this is usually of no concern, but please let us know. If it falls off sooner, please let us
know.
– Avoid re‐injury to the nose for about 6 weeks after the procedure. It takes this long for the nasal bones to become solid again. Wear headgear in a sport that would potentially re‐injure the nose

Follow up:
Schedule a followup appointment for 1 week following the procedure