Fractures of the nasal bones or cartilaginous injury may result in swelling, point tenderness, hypermobility, crepitus, epistaxis, and periorbital bruising. Diagnosis is usually clinical. Treatment may include reduction, stabilization through internal packing, and splinting. A septal hematoma is drained without delay.
The nasal bones are the most frequently fractured facial bones because of their central location and protrusion. Depending on the mechanism of injury, fractures of the maxilla, orbit, or cribriform plate and injury to the nasolacrimal ducts may also occur.
Complications include cosmetic deformity and functional obstruction. Septal hematomas are subperichondrial blood collections that may lead to avascular or septic necrosis of the cartilage with resultant deformity (saddle nose). Cribriform plate fracture may cause a cerebrospinal fluid (CSF) leak, with increased risk of meningitis or brain abscess. Fortunately, this complication is rare.