Learning Radiology - Fracture of the Nasal Bone, Nose

Fracture of the Nasal Bone

General Considerations

Most common facial bone fracture (40% of facial bone fractures)
Usually from direct blow during athletics, motor vehicle collision or an altercation; sometimes fall
Males more common
There may be associated fractures of the anterior maxillary spine, blow-out fractures of the orbit or fractures of the nasal septum

Normal anatomy of the nasal bones

Clinical Findings

Deformity of the nose
Swelling
Ecchymosis
Epistaxis

Imaging Findings

Nasal fractures may not be evident on plain films
One suture line should normally be visible at the nasofrontal suture
Otherwise, there should be no lucencies that traverse the nasal bones perpendicular to its long axis
There may be lucencies that are normally seen that traverse the nasal bones longitudinally
CT provides the best means of identifying facial fractures

Treatment

Nasal packing
Closed reduction
Surgical reduction

$nasal bone fracture$

Fracture of the Nasal Bone. There is a transverse fracture of the nasal bone (white arrow). The longitudinal line (yellow arrow) does not represent a fracture.

$nasal bone fracture$

Fracture of the Nasal Bone. Enhanced lateral radiograph shows a transverse fracture of the nasal bone (white arrow). There is also an associated fracture of the anterior nasal spine (red arrow).

Management of Acute Nasal Fractures. CJ. Kucik and J Phelan. Am Fam Physician. 2004 Oct 1;70(7):1315-1320.