Nasal Fractures: Acute, Subacute, and Delayed Management

Area of Science:

• Otolaryngology
• Plastic Surgery
• Trauma Surgery

Background:

• Nasal fractures are common injuries.
• Early closed reduction (<14 days) is often considered cost-effective and improves patient satisfaction.
• High rates of secondary open treatment are observed after initial closed reduction, particularly with septal involvement.

Purpose of the Study:

• To evaluate the effectiveness of early closed vs. delayed open treatment for nasal fractures.
• To identify factors influencing treatment outcomes, including septal involvement and timing of intervention.

Main Methods:

• Retrospective analysis of nasal fracture cases.
• Comparison of outcomes between early closed reduction and delayed open reduction (>3 months).
• Assessment of revision rates, patient satisfaction, and correction of deformities.

Main Results:

• Closed reduction of nasal fractures, especially those with significant septal involvement, frequently requires subsequent open surgery.
• Delayed open intervention (>3 months) demonstrates a lower revision rate compared to early closed techniques.
• Open approaches facilitate rigid fixation, provide better support, and allow correction of complex deformities.

Conclusions:

• Delayed open treatment for nasal fractures, particularly complex ones with septal involvement, offers superior outcomes and lower revision rates.
• Open reduction is advantageous for correcting severe bony deviations, L-strut deformities, and nasal valve issues.
• The timing and approach for nasal fracture management should be carefully considered based on fracture complexity and septal involvement.