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Reduction of a fracture

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The timing is critical. Reduction is performed either:

  • immediately - before swelling has developed
  • after 7-10 days - when the swelling has settled but the nose can still be manipulated

Reduction may be done under local or general anaesthetic:

  • the procedures usually followed are: (1)
    • closed reduction
      • limited to mild unilateral fractures.
      • can be done in the primary care setting
    • open reduction
      • usually done in the operating thaetre
  • simple lateral angulation may be reduced by digital pressure on the nose, success being greeted with an audible click
  • depressed bones may require elevation with forceps
  • a nose which is unstable after reduction should be splinted with plaster of Paris

Fractures which are reduced too late will require a formal septorhinoplasty.

Reference:

(1) Corry J. Kucik. Management of acute nasal fractures.Am Fam Physician 2004;70:1315-20

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