Broken Nose (Nasal Fracture)

How can you break your nose?

You can break your nose during play, sports, accidents, fights, and falls. If you have a lot of bleeding, pain, or other symptoms right away, then it's more likely that your nose is broken. But sometimes it's hard to know for sure. Swelling can make your nose look crooked even if it isn't broken. When the swelling goes down after a few days, it's 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.
• Clear drainage from one or both nostrils.
• 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 problems caused by a broken nose include:

• A change in how the nose or the tip of the nose looks.
• Changes in the nasal septum. This is the thin wall that divides the nose into two parts. Changes may include:
  • Swelling or a bump on the nasal septum, which may be a nasal septal hematoma.
  • A hole in the nasal septum (septal perforation).
  • Movement of the nasal septum that causes the bridge of the nose to collapse (saddle nose deformity).
  • A crooked (deviated) nasal septum.
• Permanent breathing difficulty through one or both nostrils.
• Persistent clear drainage from one or both nostrils. This may be caused by cerebrospinal fluid (CSF) draining from the brain into the nose (CSF rhinorrhea). It 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 see you again after the swelling has gone down. This may take several days.

How is a broken nose treated?

Most broken noses do not require medical treatment. If treatment is needed, it's usually done within 2 to 14 days of breaking your nose.

• A simple fracture may be treated by straightening the bone or cartilage in your nose, if it is crooked. Splints or packing the nose with gauze (nasal packing) also may be needed.
• A more complicated fracture may require surgery. Your doctor may need to move the bone or cartilage back into place. You may also need a splint or nasal packing. Antibiotics are usually given to prevent infection. Your nose may be rechecked and the packing may be removed in 2 to 5 days.

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.
• Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.
• 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.
• Don’t smoke, vape, or use other tobacco or nicotine products. These things slow healing and recovery. If you need help quitting, talk to your doctor about quit programs and medicines. These can increase your chances of quitting for good.
• Ask your doctor when it's okay to return to your usual activities.