Nasal Fracture (Pediatric)

What is a pediatric nasal fracture?

There are two nasal bones that form the “bridge” of the nose between the eyes.  Common pediatric injuries, like getting hit by a basketball, may cause one or both of these bones to break, or fracture.  Commonly, both nasal bones become “displaced,” or moved, in the same direction.  For example, if a soccer ball hits the left side of the nose, the left nasal bone may “in-fracture” towards the right, and the right nasal bone may “out-fracture,” also towards the right.  This may result in a deviated or crooked-appearing nose in addition to nasal obstruction, or trouble breathing through the nose.

What are the symptoms of a pediatric nasal fracture?

It is normal to have a nosebleed after a nasal fracture, and it usually stops by holding pressure.  However, if you notice a persistent nosebleed, other facial injuries, damage to the eye or bones around the eye, or any neurologic changes (child is very sleepy, not behaving normally, or any other concerns), you should go to the Emergency Room immediately.  X-rays may not be necessary, and the nose should be examined after the initial swelling goes down, to see if the bones are displaced.

What is the treatment for a pediatric nasal fracture?

The primary reasons to fix, or “reduce,” a pediatric nasal fracture are to correct the appearance, to prevent growth in a deviated manner, and to maintain open nasal breathing passages. 

After an injury, the bones usually heal within 14 days, so it is important to operate on the nose within two weeks after surgery.  Most pediatric nasal fractures are fixed with a “closed reduction internal fixation” of the nasal bones, which means that the nasal bones are correctly realigned without incisions.  Most children will have a firm splint on their nose after surgery to help the bones heal properly and maintain their correct position.