Fractures of the Nose

(Naso-ethmoidal complex fracture)

The bones of your nose have been fractured.  This can create difficulties with breathing and appearance of your nose.  It may be necessary for you to undergo surgery to correct the positioning of your nose.  This procedure will involve a general anaesthetic.

What does the operation involve?

Once you are put to sleep under the anaesthesia your surgeon will gently manipulate your nose back into the correct position.  This procedure generally does not involve making any incisions inside or outside the nose.  When the bones of the nose break, the cartilages in the nose can sometimes bend and may also need to be straightened.

To help protect and support your nose following surgery, a splint made may be placed inside or outside the nose.  Nasal splints are used to immobilise bones and tissues and minimise scarring and control bleeding and swelling.  Nasal splints are made of a variety of materials including silicone, aluminium and plastic. If the nose bleeds at the time of surgery, packs will be placed in each nostril.  These packs are usually removed the day after surgery.

What can I expect after the surgery?

Your nose is most likely to be sore and tender and regular pain relief will be arranged for you.  The discomfort is generally worse in the first few days following surgery, although it may take a couple of weeks to completely resolve.  Broken noses usually heal well without infection and it is not generally necessary for you be given antibiotics.

There is usually a variable amount of swelling and bruising around the eyes following surgery. These changes are most evident within the first 24 hours following surgery and tend to reduce by the end of the first week.  Swelling and bruising can be reduced by using cold compresses around the eyes and sleeping with your head elevated for the first few days following surgery.  The majority of swelling will subside after a fortnight but there is often some minor swelling that can take several months to resolve. It is also not uncommon for bruising to migrate downward.

You will generally require an overnight stay in hospital.  It is not uncommon for an x-ray to be performed of your nose following treatment of a fracture.

A follow up appointment will be arranged for review and removal of your splint.  It is important to keep any dressings as dry as possible until they are removed.

Will I require any time off work?

Depending on the nature of your work, it may be necessary for you to take some time off and avoid strenuous exercise during this time.  It is important to remember that 24 hours (depending upon your pain medication, ie. Panadeine Forte, Oxycontin) following a general anaesthetic you will not be able to drive or operate machinery. 

What are the possible complications?

Occasionally, your nose may bleed once the packs have been removed.  This usually settles by applying pressure and pinching the nose.  Rarely the packs need to be reinserted.

Some people who sustain a broken nose may require further surgery to improve the appearance and help with breathing.  This is generally not undertaken for several months until all the swelling and bruising has completely disappeared.