Abstract

This study was conducted to investigate the effectiveness of closed reduction of nasal bone fracture according to severity. It was a retrospective study carried on 60 patients with mean age of 30.2 years (range 10-67 years) who have undergone a closed reduction of a nasal bone fracture at Gandaki Medical College Teaching Hospital from January 2017 to December 2019. The patient with nasal bone fracture who underwent surgical intervention with closed reduction under General anaesthesia were included in this study. Fracture severity was evaluated according to Hwang et al.’s classification method. All patients underwent closed reduction with external nasal splinting under General anesthesia. The patients were followed-up for at least three months to assess the complications, such as fracture recurrence and functional abnormality in the Department. The most common cause of nasal bone fracture was road traffic accidents 25 (41.6%) followed by physical assaults 18 (30%), fall injuries 12 (20%), other incidences 3 (5%), and industrial accidents 2 (3%). Forty-three (72%) cases underwent closed reduction within 24 hours of those who arrived within 4-6 hour of nasal injury in the hospital and the remaining 17 (28%) cases were reduced after 5 days of trauma. Concurrent fracture found in 8 (13%) cases and it included maxillary, zygomatic, orbital, frontal bone fracture. Nasal bone fracture mostly occurs in road traffic accidents. Closed reduction with good alignment is the preferred method. Septorhinoplasty and extracorporeal septoplasty should be applied in difficult and comminuted nasoseptal fracture.

Highlights

  • The nasal bone is the most common facial bone fracture which accounts for 40% of all facial fractures.[1]

  • Aim of the study is to observe the causes, pattern and effectiveness of closed reduction by patient satisfactions grading in the treatment of the nasal bone fracture in tertiary care hospital, Pokhara

  • This is a retrospective study done in sixty patients with mean age of 30.2 years who have undergone a closed reduction of a nasal bone fracture at Gandaki Medical College Teaching Hospital from January 2017 to December 2019

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Summary

Introduction

The nasal bone is the most common facial bone fracture which accounts for 40% of all facial fractures.[1]. The closed reduction attempts to approximate and align the cartilaginous and skeletal nasal structures to their pre-trauma state and to improve the airway with minimal side effects. The management of displaced nasal bone fracture should be performed with a closed reduction in the acute setting within 1 to 2 weeks period.[4] Long-standing traumatic nasal deformities require formal septorhinoplasty. There is an abundant amount of research on nasal bone fracture reduction, it is difficult to adopt the same treatment in our population. Aim of the study is to observe the causes, pattern and effectiveness of closed reduction by patient satisfactions grading in the treatment of the nasal bone fracture in tertiary care hospital, Pokhara

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