A nasal fracture is a break in 1 or more of the bones of the nose. It’s also called a broken nose. Nasal fractures are more common in adults than in children. Children’s nasal bones are more difficult to fracture. But the nasal bone is one of the most commonly fractured bones of the face. The lower part of the nasal bone is thinner than the upper part and breaks more easily. In babies, nasal fracture can cause trouble breathing. This is because babies don't normally breathe through their mouths. A baby with a nasal fracture needs emergency treatment.
Your child may need to see an ear, nose, and throat doctor (otolaryngologist) for treatment. Treatment is based on your child’s age, overall health, and the type of injury.
Your child will need to sit upright for a time after the injury. This helps to reduce swelling of the nose. It also helps to keep blood from pooling in the nose. First treatments may include pain medicines and ice.
Any bones in the nose that are out of place will need to be lined up normally. This is called reduction. This is a common part of treatment for nasal fracture. Your child may need this right away or at a later time. A reduction may be done by moving the bones back into place (closed reduction). In some cases, surgery is done to move the bones (open reduction). Reduction is often done with general anesthesia. This means your child sleeps through the procedure and doesn’t feel pain.
After reduction, the nose may need a splint. Your child’s nose may not look exactly the way it did before. Nose surgery (rhinoplasty) may help restore the nose to a better look.
If your child’s nasal fracture is more severe, he or she might need a more complex surgery after the injury. This is called septorhinoplasty. It can help restore normal look of the nose. It also fixes a displaced nasal septum and blocked nasal airway.
Your healthcare team will work to prevent complications. Your child’s risk for possible complications may vary according to age and the extent of injury. Some possible complications include:
Pocket of infection in the septum (septal abscess)
Pocket of blood in the septum (septal hematoma)
Infection of the brain or tissues around the brain
Blocked tear duct
Abnormal connection between the nasal cavity and the mouth
Underdevelopment of the maxillary bone, making the middle of the face look sunken
Change the nose looks
Complications often need treatment, such as antibiotics or surgery.
After a nasal fracture, the nose needs time to heal. The nose is easy to injure again during this time. For this reason, most healthcare providers advise that children not play any sports for at least 2 weeks. Your child should not play contact sports such as football or wrestling for at least 6 weeks.
Call your child’s healthcare provider right away if your child has any of these:
Fever (see “Fever and children” below)
Bleeding that doesn’t stop
Nausea or vomiting
Loss of consciousness
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider.
Armpit (axillary) temperature of 99°F (37.2°C) or higher, or as directed by the provider.
Child age 3 to 36 months:
Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider.
Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider.
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider.
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
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