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For nasal fractures where the nose has been deformed, manual alignment (ie, closed reduction) may be attempted, usually with good results. Manually alignment should be performed in adults within 10 days of injury (prior to the bone healing in the misaligned state).
When a bone fractures, the fragments lose their alignment in the form of displacement or angulation. For the fractured bone to heal without any deformity the bony fragments must be re-aligned to their normal anatomical position. Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement.
The Le Fort II fracture (pyramidal fracture) includes a fracture line from one of the lateral vertical buttresses across the maxillary bone, extending into the inferior orbital rim and crossing the midline (either through the nasal root or nasal bones). [5] The defining feature of this fracture pattern is involvement of the inferior orbital rim ...
Commonly injured facial bones include the nasal bone (the nose), the maxilla (the bone that forms the upper jaw), and the mandible (the lower jaw). The mandible may be fractured at its symphysis, body, angle, ramus, and condyle. [4] The zygoma (cheekbone) and the frontal bone (forehead) are other sites for fractures. [13]
Fractures with displacement require surgery consisting of fracture reduction with miniplates, microplates and screws. Gillie's approach is used for depressed zygomatic fractures. [5] The prognosis of tripod fractures is generally good. In some cases there may be persistent post-surgical facial asymmetry, which can require further treatment. [6]
Naso-orbital fractures may involve the nasolacrimal duct. Early treatment by fracture reduction with stenting of the entire lacrimal drainage system should be considered. However, such injuries are often not recognized or are initially neglected as more serious injuries are managed.
Other signs of a basilar skull fracture include CSF otorrhea (drainage of CSF through the ear). [2] It can have devastating complications in some patients, as the communication between the nasal cavity, the cerebrospinal fluid and the central nervous system can result in severe bacterial infections.
The topmost bony part of the nose is formed by the nasal part of the frontal bone, which lies between the brow ridges, [3] and ends in a serrated nasal notch. [4] A left and a right nasal bone join with the nasal part of the frontal bone at either side; and these at the side with the small lacrimal bones and the frontal process of each maxilla. [3]