Use of fibrin glue for open comminuted nasal bone fractures

Nasal bone fractures are the most common type of facial fracture. Closed reduction has been used as the standard treatment modality for nasal fractures for many years. In cases of nasal fracture with lacerations at the fracture sites, bioabsorbable/metallic plate or interfragment wire fixation can be used with accurate alignment through the openings created by the lacerations. However, in cases of severe comminuted nasal fractures that are difficult to drill and fix, this type of fixation may not be feasible. We performed in 5 patients open reduction with internal fixation through laceration openings using the biomaterial Greenplast (Greencross Corporation, Seoul, Republic of Korea; human plasma fibrinogen, thrombin, aprotinin, and calcium chloride) under general anesthesia. Both structural and aesthetic outcomes were satisfactory. Open reduction through laceration openings and internal fixation with fibrin glue under general anesthesia may be a simpler and more effective method than those currently in general use for the repair of complicated comminuted open nasal fractures.