Pre- and postoperative x-ray and computed tomography evaluation in acute nasal fracture

Between January 1997 and July 2003, 156 acute nasal fractures were treated by closed reduction in Ishikiri-Seiki Hospital. For all patients, x-ray and computed tomography (CT) taken pre- and postoperatively were used to classify fractures and evaluate postoperative conditions. Acute nasal fractures requiring surgery were classified into the following 5 types. Unilateral type (U), bilateral type (B), frontal type (F), laterofrontal type (L), and comminuted type (C). Postoperative conditions were classified as good, fair, or poor. On statistical analysis, it was found that reduction is easier in the U, F, B, L, and C types in order. Furthermore, it was found that in the U, B, and F types, reduction can be performed after swelling has subsided, but in the L and L+C types, reduction should be performed earlier. On follow-up x-ray and CT, there was no significant difference between the postoperative evaluation and follow-up evaluation. A few overreduced cases improved, but correct reduction was preferable to overreduction. Accurate preoperative understanding of the fracture type and postoperative evaluation by x-ray and CT are necessary to obtain good results and to decrease secondary deformity caused by poor primary reduction.