Broken Nose (Nasal Fracture)

Condition Basics

How can you break your nose?

You can break your nose during play, sports, fights, and falls. But it may be hard to tell if your nose is broken. Swelling can make your nose look crooked even if it is not broken. When the swelling goes down after a few days, it is easier to tell if your nose is really crooked and possibly broken.

What are the symptoms?

Symptoms of a broken nose include:

• Nose pain.
• Swelling of the nose.
• A crooked or bent appearance.
• Bruising around the nose or eyes.
• A runny nose or a nosebleed.
• A grating sound or feeling when the nose is touched or rubbed.
• Blocked nasal passages.

What problems can a broken nose cause?

Possible complications of a broken nose include:

• Change in the appearance of the nose or the tip of the nose.
• Swelling or a bump on the thin wall (nasal septum) between the nostrils of the nose (nasal septal hematoma).
• A hole in the nasal septum (septal perforation) or causing the bridge of the nose to collapse (saddle nose deformity).
• Crooked (deviated) nasal septum. The nasal septum is the structure that divides the nose into two parts.
• Permanent breathing difficulty.
• Persistent drainage from one or both nostrils. This may be caused by cerebrospinal fluid draining from the brain into the nose (CSF rhinorrhea) and can occur after a head injury or after surgery on the nose or ears.
• Infection of the nose, sinuses, or facial bones.
• A change in or loss of sense of smell.

How is it diagnosed?

A broken nose is diagnosed through a physical exam and medical history. An X-ray of the nose may be done. If other facial injuries or fractures are suspected, a CT scan will be done. Your doctor may wish to delay evaluation until the swelling has gone down. This may take several days.

How is a broken nose treated?

Immediately after the fracture, apply ice and keep your head elevated. You may need pain medicine, such as acetaminophen (for example, Tylenol). Be safe with medicines. Read and follow all instructions on the label. Do not take non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil or Motrin) or aspirin, for 48 hours after a nose injury. Do not take aspirin if you are younger than 18 because of the risk of Reye syndrome.

Immediate treatment is needed for some injuries that occur with a broken nose, such as:

• Swelling or a bump on the thin wall (nasal septum) between the nostrils of the nose (nasal septal hematoma).
• A nosebleed that you cannot stop (epistaxis).
• Clear drainage from one or both nostrils (CSF rhinorrhea).

Treatment, if needed, usually is done within 7 to 14 days of breaking your nose. Most broken noses do not require treatment other than controlling pain and other symptoms.

• Your doctor may treat a simple fracture by straightening the bone or cartilage in your nose, if it is crooked. Splints or nasal packing (packing the nose with gauze) also may be necessary.
• Surgery may be needed to treat a more complicated fracture. Your doctor may need to move the bone or cartilage back into place. Splints or nasal packing may be necessary. Antibiotics are usually given to prevent infection. Your nose may be rechecked and the packing may be removed in 48 to 72 hours.

How can you care for your broken nose?

• If you have a nasal splint or packing, leave it in place until a doctor removes it.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Take decongestants as directed to help you breathe after the splint or packing is removed. Your doctor may give you a prescription or suggest over-the-counter medicine.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• Put ice or a cold pack on your nose for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the first 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice pack and your skin.
• Sleep with your head slightly raised until the swelling goes down. Prop up your head and shoulders on pillows.
• Ask your doctor when it's okay to return to your normal activities.