Disease Information for Fracture, nasal bone (Clinical Manifestations)

Closed fracture nasal bone, Closed fracture nose, Closed fracture of nasal bones, Closed fracture of nasal bones (disorder), Nasal bones closed fracture

Nasal bone fracture: minor nasal trauma history; Epistaxis; observe for associated injuries with Cervical Spine Injury; Mandibular fracture; Facial fracture; Zygomatic arch fracture; Maxillary sinus fracture; Orbital fracture; External exam: Clinical diagnosis (not radiographic); Localized Edema and Ecchymosis of nose; Nasal deformity: Birds Eye View;Palpate nose for crepitation or step-offs; Compare to photo before injury (best available); Use driver"s license if others not available; Internal exam; Apply anesthesia and vasconstrictor to mucosa and nasal speculum exam Assess Nasal Airway patency; Assess for continuing Epistaxis ; Assess turbinates: Septal Hematoma ; clear Rhinorrhea (possible CSF) Complications: Evaluate for in all cases; Septal Hematoma: Observe for white or purple swelling on septum; Depress septal mucosa to check for fluctuant area; Failed diagnosis may result in saddle deformity; CSF Rhinorrhea: Presents as clear Rhinorrhea; Double Ring Sign (variable efficacy); Place bloody Nasal discharge on filter paper May form double ring on paper if CSF present; Immediate consultation indications: Cerebrospinal fluid leak suspected; Limited extraocular movement (orbital fracture); New malocclusion of teeth (jaw joint or mandibular fracture); Altered mental status (closed head trauma/concussion); Radiology: Nasal X-Ray is not recommended; Low Test Sensitivity and Test Specificity instead Coronal CT of facial bones Indications Suspected facial fracture or Clear Rhinorrhea with CSF leak suspect; Closed Reduction Administer Conscious Sedation and analgesia; (Versed and Morphine IV Titrate to adequate effect) ; Instruments used Asch forceps and Walsham forceps or Boies elevator (preferred)---------[adapted Family Practice Notebook 2004]-----------

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