Modification of classification of nasal bone fracture assisted under picture archiving and communication system

The nasal bone fracture is the most common type of facial bone fracture. The fractures have been described and classified by many authors. However, studies analyzing surgical outcomes and classifications are limited.

We aimed to update a detailed classification based on preoperative Computed Tomography Scan(CT) to improve surgical outcomes and assist clinicians in planning the operative approach.

A total of 135 patients with nasal bone fractures visited the Department of Otorhinolaryngology between March 2000 and November 2025. The modified classification system was applied to several patients in whom nasal bone fracture was identified.

A retrospective review of 135 cases included 80 male and 55 female patients, aged 6 to 83 years (mean age, 43.5 years), all presenting with various types of nasal bone fractures. The distribution of patients according to our modified classification system is summarized as follows. Type I fractures were identified in 33 patients. Type IIA-d fractures were present in 53 patients, with 9 cases showing excellent reduction, 1 case fair reduction, and the remaining cases demonstrating good reduction. Type IIA-e fractures occurred in 9 patients, of whom 3 achieved excellent reduction, while the remainder showed good reduction. Type IIB-de fractures were observed in 17 patients, including 3 cases with excellent reduction. Type IIB-ed fractures were noted in 7 patients. Type IIB-dd fractures were found in 25 patients, with 1 case achieving excellent reduction. No cases of Type IIB-ee fractures were identified. Type III fractures were observed in 1 patient.

We hope that future research on our modified classification will positively influence the clinical categorization and management of nasal bone fractures, ultimately leading to improved surgical outcomes and prognosis.