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Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Defining National Benchmarks for Operative Nasal Fracture Management: Perioperative Outcomes Across Nearly Two
Georgios Karamitros1,2, Georgios Bouloukakis3, Agata Szulia2
1Departments of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN.
The Journal of Craniofacial Surgery
|July 9, 2026
Summary
Operative nasal fracture repair is safe with low complication rates, regardless of surgical approach. Injury complexity, not patient risk, determines if open or closed reduction is used, establishing a new national safety standard.
Area of Science:
- Facial reconstructive surgery
- Trauma surgery outcomes
- Healthcare quality metrics
Background:
- Nasal fractures are common, but benchmarks for surgical outcomes and decision-making are lacking.
- This study uses extensive national data to set perioperative safety standards for nasal fracture repair.
- It also investigates factors influencing the choice between open and closed reduction techniques.
Purpose of the Study:
- To establish contemporary national benchmarks for perioperative safety in operative nasal fracture repair.
- To identify key factors influencing the selection of surgical approach (open vs. closed reduction).
- To analyze specialty practice patterns and outcomes in managing nasal fractures.
Main Methods:
- Retrospective cohort study utilizing the ACS-NSQIP database (2007-2024).
- Inclusion of adult patients undergoing operative nasal fracture repair, stratified by surgical approach.
- Primary outcome: 30-day postoperative complications; secondary outcomes: determinants of approach, impact of concurrent procedures, and specialty differences.
Main Results:
- Operative nasal fracture management showed a low overall complication rate of 1.5% across nearly two decades.
- No significant difference in complications between closed (1.4%) and open (2.2%) reduction approaches.
- Operative time and wound classification predicted open reduction; patient comorbidity did not. Otolaryngology and plastic surgery demonstrated equivalent complication rates.
Conclusions:
- Operative nasal fracture management is uniformly safe with minimal perioperative morbidity nationally.
- Surgical approach is driven by injury complexity, supporting an anatomy-based treatment strategy.
- These findings establish a national reference standard for perioperative safety in nasal fracture repair.
