Broken Nose (Nasal Fracture)

What Is It?

A broken nose is a fracture (crack or break) of the nasal bones. In most cases, there is also some damage to nearby nasal cartilage, particularly the nasal septum, the flexible partition that divides the left and right sides of the nose.

Because the nose has such a prominent and unprotected position in the center of the face, it is particularly vulnerable to impacts from accidents and violence. In mild fractures, the injury causes only some mild swelling and a brief nosebleed, so you may be unaware of the break unless your nose heals with a slight deformity. In severe fractures, however, the nose can be obviously deformed or shifted out of its normal midline position immediately after impact. There also may be a severe nosebleed, a blocked nostril or air-flow problems related to a deviated septum (a shift of the nasal septum toward the left or right nostril).

Health care experts do not know how often broken noses occur, because many people who have mild nasal fractures do not seek treatment. Among adults and teenagers treated by doctors, the most common causes of nasal fractures include contact sports, car crashes, motorcycle accidents and violent assaults. In particular, athletes are at high risk of a broken nose if they participate in soccer, basketball, baseball, boxing, martial arts (especially kickboxing), wrestling, handball, racquetball or mountain biking. Although the nose is also an easy target for fractures during hockey and football games, helmets used in these sports provide some protection against facial injuries. In a similar way, protective helmets may reduce the risk of nasal fractures (as well as more severe injuries) in people who ride motorcycles or bicycles. Among victims of car crashes, the increased use of seat belts and airbags over the past three decades has dramatically reduced the incidence of broken noses from dashboard impacts.

In infants, the nasal bones sometimes are fractured at the time of delivery. In older children, nasal fractures often are caused by a fall, a bicycle accident, contact sports or child abuse. In general, children tend to be at lower risk of a broken nose than adults because a child's immature bones are generally less brittle and more flexible. However, the long-term risk for nasal deformities or breathing problems is often greater when a nasal fracture happens during childhood because a child's nasal bones and cartilage have not finished growing.

Symptoms

Symptoms of a broken nose include:

• Bruising, swelling and tenderness around the nose
• Nosebleed
• A deformed, twisted or crooked nose
• Blockage of one or both nostrils
• A deviated septum
• A bruise-like discoloration under the eyes