A broken nose involves a crack or break in the bone or cartilage that forms the structure of the nose. This is the most common facial fracture, typically caused by a direct blow from contact sports, falls, or accidents. Symptoms include immediate pain, swelling, nosebleeds, and often a visible deformity or crookedness. Prompt medical attention is required to ensure proper healing and to avoid potential long-term breathing issues or cosmetic deformities.
Immediate First Aid and When to Seek Emergency Care
The moment a nasal injury occurs, the first steps involve controlling bleeding and reducing immediate swelling. Sit upright and lean slightly forward, which helps prevent blood from running down the back of your throat. Gently pinch the soft, fleshy part of the nose below the bony bridge with your thumb and index finger, holding firm pressure for up to 15 minutes.
To minimize swelling and pain, apply a cold compress or an ice pack wrapped in a thin cloth to the nose for 10 to 20 minutes at a time. Acetaminophen is generally the preferred over-the-counter pain reliever initially, as NSAIDs like ibuprofen can potentially increase bleeding risk. Seek emergency medical care immediately if you experience heavy, uncontrollable bleeding, or if clear, watery fluid is draining from the nose, as this may indicate a serious head injury. Other red flags for an emergency room visit include severe difficulty breathing, a noticeable change in vision, or signs of a head or neck injury, such as loss of consciousness or severe headache.
Medical Diagnosis and Setting the Fracture
Diagnosis of a nasal fracture is often made through a physical examination. The doctor will visually inspect and gently touch the nose to feel for displacement or unstable bone fragments. Imaging like X-rays or CT scans is sometimes used if other facial injuries are suspected or if the injury is complex, but it is not always necessary for a simple fracture.
The timing of fracture correction is a significant factor in successful treatment. Doctors often recommend waiting three to five days for the initial swelling to subside before attempting to realign the bones. The corrective procedure, known as a reduction, must ideally be performed within 7 to 14 days of the injury, as the bones begin to solidify in their new position after this window.
For less severe fractures, a Closed Reduction is the typical treatment, involving manually manipulating the bones back into place without an incision. This is often performed under local anesthesia and sedation using specialized instruments inserted into the nostrils. More complex fractures, those involving significant displacement or affecting the nasal septum, may require an Open Reduction. This surgical procedure is performed through an incision, allowing the surgeon direct visualization and more accurate manipulation of the bone and cartilage.
Managing Recovery and Healing at Home
Following a reduction procedure, or if the fracture did not require realignment, recovery focuses on pain control and protecting the nose. Prescription pain medication may be provided, but over-the-counter options are often sufficient once the initial discomfort subsides. Swelling and bruising are expected, particularly around the nose and under the eyes, with bruising typically resolving within two to three weeks.
Keeping your head elevated, especially while sleeping, helps to reduce swelling and congestion in the first few days post-injury. If the nose was packed internally or held with an external splint, you must follow the doctor’s instructions for its care and removal. Nasal packing, if used, is usually temporary and helps to stabilize the septum and control bleeding.
Activity restrictions are required for several weeks to prevent re-injury or displacement of the healing bones. You must avoid contact sports for at least six weeks, and refrain from strenuous activity for the first two weeks. Avoid wearing glasses that rest on the bridge of the nose until the swelling is completely gone, as this pressure can interfere with proper healing.
Recognizing and Addressing Potential Complications
While most nasal fractures heal without issue, certain symptoms may signal a complication that requires immediate medical attention. The most time-sensitive complication is a Septal Hematoma, a collection of blood that forms between the cartilage and the lining of the nasal septum. An untreated septal hematoma can cut off the blood supply to the septal cartilage, leading to tissue death and a potential “saddle nose” deformity, where the bridge of the nose collapses.
Signs of a septal hematoma include painful, spongy swelling inside the nose that blocks both nostrils, or severe, worsening nasal obstruction. This condition requires urgent drainage by a doctor to prevent permanent damage. Persistent nasal obstruction after the initial swelling has resolved may indicate a deviated septum, where the wall dividing the nostrils is shifted. This structural issue may necessitate a later surgical procedure, known as a septoplasty, to improve breathing. Watch for signs of infection, such as a fever or increasing redness and pain around the nose, and contact your healthcare provider immediately.