Broken Nose – Diagnosis and Treatment
Diagnosis
A healthcare provider gently presses on the outside of the nose and nearby areas to check for pain, swelling, or changes in shape.
They may use a small light to look inside the nasal passages for blockages, bruising, or bleeding from a broken nose. Numbing medicine helps keep the patient comfortable during the checkup.
Imaging:
- Doctors rarely use X-rays for nasal fractures.
- They may order a CT scan if facial injuries are serious or if they suspect other bone damage.
Nosebleeds, tenderness, and swelling are common signs. Facial trauma can cause deformity or blocked nostrils.
If a septal hematoma or abscess develops, urgent care is needed to prevent complications like a saddle nose deformity. Imaging helps when swelling makes it hard to feel the nose structure.
Treatment
Setting the Nose Back into Place
When a broken nose moves the bones or cartilage out of place, doctors can push them back. They do this best within two weeks after the injury.
The patient receives medicine to numb the nose area. Sometimes, doctors use their hands or special tools to straighten the nose.
They may place packing or a small splint inside the nostrils. A dressing or an external splint might go on the outside for support.
Packing usually stays up to seven days. The outside splint or dressing can stay for as long as two weeks. Doctors may give antibiotics to prevent infection.
Surgical Treatment for Nose Fractures
If the break is severe or if too much time has passed, doctors may need to do surgery. Surgery moves the bones back and restores the shape of the nose.
If the break injures the nasal septum, surgery can help breathing. Doctors use two main types of operations:
- Closed Reduction: Realigns bones without large cuts.
- Open Reduction or Septorhinoplasty: Repairs more complex issues, sometimes using cuts inside or outside the nose.
Doctors use local or general anesthesia depending on the case. People with nose injuries should follow up with their doctor. They should watch for infection, ongoing bleeding, or trouble breathing and seek help if these happen.
Ways to Care for Yourself at Home
You can manage pain and swelling at home after a nose injury. Wrap ice in a clean cloth and place it gently on the nose for 10 to 15 minutes at a time. Do this up to four times a day during the first two days.
| Step | Details |
|---|---|
| Ice Packs | 10-15 min, up to 4x/day, wrapped in cloth |
| Pain Relief | Use acetaminophen, ibuprofen, or naproxen |
| Head Elevated | Sleeping/resting with head up |
| Activity Limit | No sports or rough play for 2-6 weeks |
Never put ice directly on the skin to avoid frostbite. Use only light pressure to reduce discomfort.
You can use over-the-counter medicines like acetaminophen, ibuprofen, or naproxen for pain or headache. Keep your head raised, even while sleeping, to help limit swelling.
If your nose bleeds, lean forward to stop blood from going into your throat.
Limit activities and avoid contact sports or heavy exercise, especially during the first two weeks. Returning to normal activity too soon may increase pain or slow recovery.
Getting Ready to See Your Doctor
Steps You Can Take Before the Visit
Taking the right steps before your appointment helps make the visit more helpful. This matters for adults, children, and those in contact sports.
Track your symptoms. Write down your symptoms and what you were doing when you hurt your nose. Note if pain, swelling, or other problems have changed over time.
List your medicines and supplements. Make a list of everything you take, including prescription medicine, vitamins, or herbal supplements. This helps the healthcare provider, especially for children or people with health issues.
Bring a recent photo. If possible, bring a clear photo from before the injury. This helps the provider see how your nose looked before and spot any changes.
Prepare questions. Write down what you want to know. Common questions include:
| Question | Why Itโs Useful |
| Will I need any tests like X-rays? | To learn if the bone is broken or out of place. |
| Will my nose look the same as before? | To plan for cosmetic concerns. |
| How long should swelling and bruising last? | To prepare for healing time. |
| Is surgery needed, or can it heal on its own? | To know all treatment options. |
| Is it safe to return to sports or gym activities? | For anyone who plays contact sports. |
| What pain relievers are safe to use? | To avoid side effects or drug interactions. |
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Monitor for serious symptoms. Get medical advice sooner if you have:
- Difficulty breathing through the nose
- Worsening pain or swelling
- Nose appears crooked after swelling goes down
- Frequent nosebleeds
- Fever
- For Children and Teens: Parents should watch for changes closely. Kids may not always explain symptoms well. For athletes, tell the doctor about any planned sports so they can advise about safe return.
Questions the Doctor Might Ask and What You’ll Experience
Knowing what the healthcare provider might do or ask helps you prepare for your visit.
Details About the Injury: The provider may ask how and when your nose was hurt. Try to remember the accident details. If your child is the patient, share what you saw or what your child told you.
Progress of Symptoms: The provider may ask if pain, swelling, or other signs are improving or getting worse.
Appearance Changes: Expect questions like, โDoes your nose look different now?โ or โIs there any obvious change since the injury?โ A recent pre-injury photo can help.
Breathing Checks: The doctor or ENT specialist will ask if you can breathe through both sides of your nose after swelling goes down.
Activity and Sports: If you or your child plays contact sports, the provider may discuss when it’s safe to return. For younger kids, they may ask about play habits or roughhousing.
Medical History and Medicines: They will likely ask about past nose injuries, surgeries, or health conditions that could affect treatment.
Physical Exam: The provider gently touches and looks at your nose and face. Sometimes, they suggest extra tests like X-rays, especially if the nose still looks bent or if breathing is difficult.
Referral to a Specialist: Not all broken noses need an ENT specialist, but your provider may refer you if the injury is serious or if surgery might be needed.
Bring your information and questions in a notebook or on your phone. Caregivers for children should bring notes about symptoms or changes. If you have paperwork from a school nurse, coach, or other provider, share it during the visit.
