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Comparison of postoperative outcomes between early and delayed surgery for pediatric nasal fractures
Won Ki Kang1, Dong Gil Han1, Sung-Eun Kim1
1Department of Plastic and Reconstructive Surgery, Daegu Catholic University School of Medicine, Daegu, Korea.
Insights
Delayed surgery for pediatric nasal fractures shows comparable outcomes to early intervention. Successful surgical results are achievable even when treatment is delayed more than 7 days post-trauma.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Orthopedic Surgery
Background:
- Pediatric nasal fractures often require surgical intervention within 7 days of trauma.
- Limited research exists on the impact of delayed surgical treatment for pediatric nasal fractures.
- This study investigates postoperative outcomes based on the timing of surgical intervention for pediatric nasal fractures.
Purpose of the Study:
- To evaluate and compare postoperative outcomes of pediatric nasal fractures treated with early versus delayed surgical reduction.
- To determine if a delay in surgery impacts the success rate of closed reduction for nasal bone fractures in children.
Main Methods:
- Retrospective review of pediatric patients (<12 years) undergoing closed reduction for nasal bone fractures (March 2012-February 2020).
- Patients categorized into 'early reduction' (within 7 days) and 'delayed reduction' (more than 7 days) groups.
- Postoperative outcomes assessed using computed tomography (CT) and graded (excellent to very poor).
Main Results:
- Ninety-eight patients analyzed: 51 in the early group, 47 in the delayed group.
- Excellent or good outcomes achieved in 100% of the early reduction group and 100% of the delayed reduction group.
- No significant difference in outcomes between early and delayed reduction groups (p=0.937).
- Absence of septal injury correlated with significantly better outcomes (p<0.01).
Conclusions:
- Surgical timing (early vs. delayed) does not significantly affect postoperative outcomes for pediatric nasal fractures.
- Delayed reduction (over 7 days post-trauma) can yield successful surgical results.
- Septal integrity is a key factor in achieving excellent postoperative outcomes for pediatric nasal fractures.
Background:
Pediatric nasal fractures, unlike adult nasal fractures, are treated surgically as early as 7 days after the initial trauma. However, in some cases, a week or more elapses before surgery, and few studies have investigated the consequences of delayed surgery for pediatric nasal fractures. The purpose of this study was to evaluate the postoperative outcomes of pediatric nasal fractures according to the time interval between the initial trauma and surgery.
Methods:
The records of pediatric patients under 12 years old who underwent closed reduction of nasal bone fracture from March 2012 to February 2020 were reviewed. The interval between trauma and surgery was divided into within 7 days (early reduction) and more than 7 days (delayed reduction). Postoperative results were classified into five grades (excellent, good, moderate, poor, and very poor) based on the degree of reduction shown on computed tomography.
Results:
Ninety-eight patients were analyzed, of whom 51 underwent early reduction and 47 underwent delayed reduction. Forty-two (82.4%) of the 51 patients in the early reduction group showed excellent results, and nine (17.6%) showed good results. Thirty-nine (83.0%) of the 47 patients in the delayed reduction group showed excellent results and eight (17.0%) showed good results. No statistically significant difference in outcomes was found between the two groups (chi-square test p= 0.937). However, patients without septal injury were significantly more likely to have excellent postoperative outcomes (chi-square test p< 0.01).
Conclusion:
No statistically significant difference was found in the outcomes of pediatric nasal fractures between the early and delayed reduction groups. Successful surgical results were found even in patients who received delayed reduction (more than 7 days after trauma).
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