A Nasal Bone Fracture Caused by a Dog Bite in an Adult

The authors report a case of nasal bone fracture caused by a dog bite in a 25-year-old woman.A 25-year-old woman presented with lacerations of the face caused by a dog bite. When visiting her friend's house, a malamute attacked her. The dog's maxillary teeth bit her right canthal area and right infraorbital area, and the mandibular teeth traversed her left cheek through the buccal mucosa. She had full-thickness lacerations on the left cheek from the skin to the buccal mucosa, and deep lacerations in the right infraorbital area and the right medial canthal area. She had tenderness on the dorsum and right side of her nose. Computed tomography revealed a depressed nasal bone fracture on the right side. The wound was irrigated using betadine solution, and antibiotics were injected. On the seventh post-trauma day, closed reduction and delayed primary repair were performed.The biting force of German shepherds, huskies, and malamutes is approximately 320 pounds per square inch. The nasal bones are the most fragile facial bones, and their tolerance levels for minimal fractures are in the 25 to 75 lbs range. The maxilla has low tolerance level (140-445 lbs). The zygomatic arch is relatively fragile (tolerance level, 208-475 Ibs), while the zygomatic body has higher tolerance level (200-450 lbs). Thereafter, the biting strength of these dogs suffices to fracture the nasal bone, maxilla, or even zygoma.When a dog bite injury occurs near the orbit, nose, and cheek, facial fracture should be suspected in both children and adults.