NASAL BONE  FX

 

S & S:

  1. Deformity.
     
  2. +/- epistaxis
     
  3. R/O septal hematoma -bulging bluish discoloration on nasal septal mucosa.
     
  4. Ethmoid/Cribriform sinus fx due to transmitted forces with consequent CSF leak (@ bed side diagnosed with (+)ve glucose on deepstix and halo formation on filter paper).

DX:

  1. See in "overview"
     
  2. Generally x-rays are not necessary since, even if fx is evident and there is displacement, therapy is delayed for 1 week until swelling had diminished. X-rays are more useful to r/o ethmoid fx

Treatment:

  1. In ER treatment should be directed towards the following complications:
     
    1. Septal hematoma must be drained since it will cause nasal deformity.
       
    2. Epistaxis (see elsewhere)
       
    3. Ethmoid fx and CSF leak require antbx and neurosurgical consult.
       
  2. Refer to ENT or Plastic surgery

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