CONDITION / CARRY

Fresh fracture of the nose.

Fracture of the nose is the most frequent fracture of facial bones. If the bones have shifted, they are exercised closed, without incisions, preferably in the first two weeks; and septal hematoma, if present, must be drained immediately.

Discuss your case How it is treated in the clinic ↓

CONCEPTUAL VISUALIZATION

BRIEFLY

what is it: Fracture of the bones of the nose, often together with the cartilage and septum.
When to reduce it: Closed - usually in the first 2 weeks after the injury, when the swelling has subsided.
What is urgent?: Septal hematoma - it is released immediately, otherwise the cartilage may die.
Who treats: ENT doctor or surgeon who works with the nose.

01 / WHAT IS IT

What is a
fracture of the nose.

The bones of the nose are broken most often of all the bones of the face. Together with them, cartilage and septum are often damaged. The fracture can be without displacement - then the nose keeps its shape - or with displacement, when the back deviates or sinks.

The goal of treatment is to restore the shape and breathing of the nose as it was before the injury and reduce the likelihood of repeat surgery in the future.

Untreated displaced fractures can lead to a crooked or saddle-shaped nose and difficulty breathing. They can also be corrected, but by planned and more complicated operation.

This is general information. Tactics in your case will be determined by the doctor after the examination.

02 / SIGNS

How to understand
that the nose is broken.

Swelling in the first days can hide the displacement. Therefore, it is important to see a doctor even after it subsides.

Pain and swelling

The nose hurts to the touch, quickly swells.

Displacement

The back leaned to the side or sunk in, a hump appeared.

Nose after injury

Bleeding

Blood from the nose immediately after the blow; it usually stops if you press the wings of the nose.

Breathing

One or both halves of the nose do not breathe.

Septal hematoma

Congestion, pain, swelling inside the nose - possible accumulation of blood under the mucous membrane.

03 / REASONS

Why the
nose breaks.

The causes differ in adults and children, according to a review of 26 studies.

Adults

Fights (36.3%), traffic accidents (20.8%), sports (15.3%) and falls (13.4%).

Children

Sports are the most common (59.3%), followed by fights and road accidents.

Partition

If the septum is also broken, breathing problems often remain after closed reduction.

Distortion of the septum

04 / SEEK MEDICAL ADVICE

When do you need help?

Most nasal fractures are not life-threatening, but a few signs require immediate attention. Septal hematoma is diagnosed on average only 8 days after the injury — although it must be released immediately.

103 immediately if:

bleeding does not stop after 15 minutes of pressing;
loss of consciousness, severe headache, vomiting, double vision after impact;
a clear liquid flows from the nose.

To the doctor on the same day, if:

The nose is strongly blocked with pain and swelling inside, a temperature has appeared - this is how a hematoma or abscess of the septum is manifested. If the nose is displaced, but the breathing is normal, see a doctor within a few days, when the swelling subsides a little.

05 / DIAGNOSTICS

How the
diagnosis is made.

Discussion and review
How the injury happened, how the nose looked before it; examination of form and swelling.
Examination of the nose from the inside
Search for hematoma and septal fracture.
Pictures as needed
CT scan — if there is suspicion of fractures of other facial bones.
Re-examination
After a few days, when the swelling has subsided, to assess the displacement and decide if a reduction is needed.

06 / TREATMENT

How to treat
fracture of the nose.

Treatment depends on the displacement, the condition of the septum, and the time since the injury.

The first two weeks

Closed adjustment: The bones are returned to their place without incisions. Early closed reduction (up to 14 days) is described in the literature as a way to reduce the need for repeat operations. In one study, more than 90% of patients were satisfied with the procedure, in another study (400 patients), 77.5% were satisfied with breathing, and 85.6% with the shape of the nose.
Septal hematoma: If there is, it is released immediately. Among the consequences of hematoma and abscess, deformation or destruction of septal cartilage is the most common (14.3%).
Broken partition: After only closed reduction, obstruction remained in 22.2%, and with early septoplasty - in 5.9% (meta-analysis of 1117 patients).

If time has passed

Late adjustment: After 2 weeks, the bones were more difficult to close, although in a series of 10 patients this was achieved on average at day 22, and in another study, satisfaction was maintained with the exercise up to 5 weeks after injury.
Planned correction: If the nose has grown crooked, it is corrected with septorhinoplasty - usually after 3 months or later.

What to expect

Residual changes: Approximately one in ten patients remains deformed, deviated septum, or blocked after treatment.

07 / AT THE VALIKHNOVSKY CLINIC

How do we
treat it.

Nasal fractures are treated in Dr. Valikhnovsky's Institute of Surgery in the "New Nose" direction — from closed reduction to planned correction of the consequences.

DIRECTION TO THE CLINIC A new nose Shape, support and breathing of the nose: septum, concha, sinuses, consequences of injuries, failed operations and removal of tumors. Go to direction

What do we do in this condition

Closed adjustment — a fresh fracture with displacement is performed without incisions in the skin.
Post-traumatic septoplasty — if the septum is also broken.
Osteotomy and septorhinoplasty — if the bones have already fused incorrectly.

Rostislav Valikhnovsky

Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovsky Institute of Surgery.

Publications by topic

Article on the principles of diagnosis and treatment in reconstructive surgery of acquired nasal defects — Clinical Surgery, 2009 (PubMed).

About the doctor ORCID

How is the treatment in us

Contact immediatelyCall or send a photo - the doctor will tell you when to come for an examination. If there are signs from the "When to seek medical advice" section, call 103 immediately.
ReviewAssessment of displacement, partitions, search for hematoma.
PlanAdminister now, after swelling subsides, or plan correction later.
AdministrationClosed, without incisions; if necessary, together with the correction of the partition.
ControlRe-examination after the swelling subsides; if there are any changes, a correction plan.

Discuss your case to call

08 / QUESTIONS AND ANSWERS

Frequently asked
questions.

Short answers. What is right for you, the doctor will tell you during the consultation.

How to understand that the nose is broken?

Pain, swelling, bleeding, displacement of the back, difficulty breathing. Swelling can hide the displacement, so you should see a doctor.

Until what time can you adjust the nose?

Closed - preferably in the first 2 weeks. Later, the bones grow, and the nose is corrected as planned, usually after 3 months or later.

What is septal hematoma and why is it dangerous?

Accumulation of blood under the mucous membrane of the septum. Without treatment, the cartilage can die, and the nose can be spared. She is released immediately.

Is surgery necessary if the nose is not displaced?

Usually not. A nondisplaced fracture heals on its own, but an examination is needed to avoid a hematoma or a septal fracture.

Can the nose be corrected if it has grown crooked?

Yes, septorhinoplasty is planned. In a study of 400 patients, 11% eventually required such surgery.

Does the reduction always give a flat nose?

Not always. According to a review of 12 studies, about one in ten left a deformity, septal curvature, or obstruction after treatment. They can be fixed later on schedule.

Is it possible to exercise the child's nose?

Yes. In children, the most common cause of fracture is sports. Tactics are determined by the doctor taking into account age.

09 / SOURCES

Sources

11 sources · reviews, guidelines and studiesShowCollapse

Acute Management of Nasal Bone Fractures: A Systematic Review and Practice Management GuidelineAmerican Surgeon, 2026doi:10.1177/00031348251358429 ↗
Early Septoplasty Versus Closed Reduction for Acute Nasoseptal Fracture: A Systematic Review and Meta-analysisOtolaryngology–Head and Neck Surgery, 2025doi:10.1002/ohn.1007 ↗
Complications of Nasal Bone FracturesJournal of Craniofacial Surgery, 2017doi:10.1097/SCS.0000000000003482 ↗
Etiology of Nasal Bone FracturesJournal of Craniofacial Surgery, 2017doi:10.1097/SCS.0000000000003477 ↗
Septal fractures predict poor outcomes after closed nasal reduction: Retrospective review and surveyLaryngoscope, 2019doi:10.1002/lary.27781 ↗
Acute nasal fracture management: A prospective study and literature reviewLaryngoscope, 2015doi:10.1002/lary.25358 ↗
Delayed Reduction of Nasal Bone FracturesArchives of Craniofacial Surgery, 2016doi:10.7181/acfs.2016.17.2.51 ↗
Unmasking Nasal Septal Hematoma/Abscess: A Systematic Review and Meta-analysisOTO Open, 2024doi:10.1002/oto2.174 ↗
Nasal Fractures: The Role of Primary Reduction and Secondary RevisionFacial Plastic Surgery, 2019doi:10.1055/s-0039-1700801 ↗
Nasal Fractures: Acute, Subacute, and Delayed ManagementOtolaryngologic Clinics of North America, 2023doi:10.1016/j.otc.2023.05.004 ↗
The Management of Posttraumatic Nasal DeformitiesFacial Plastic Surgery, 2023doi:10.1055/a-2152-8670 ↗

The figures on the page are from these sources.

VALIKHNOVSKI SURGERY PARTNERS

Have you just injured your
nose?

Call or send a photo - the doctor will tell you if you need help now and when it is better to exercise your nose.

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