Classification of Nasal Bone Fracture; Types and Secondary Deformities

Ha, Jae Seong; Lee, Keun Cheol; Kim, Seok Kwun; Park, Jung Min

Abstract

The nose is the most prominent and chracteristic feature of the human face, and nasal bone fracture is the most common facial bone fracture, resulted from less force others fractures. Although nasal fracture is often discussed as minor injury, the incidence of posttraumatic nasal deformity remains high. We reviewed the data from 380 consecutive patients with nasal bone fracture treated in Dong-A University Hospital from Jannuary 1995 to December 2001 to analysis. We classified the nasal bone fracture according to the severity of fracture. Type I is simple and unilateral nasal bone fracture, Type II is simple and bilateral, Type III is communited, Type IV is complex (nasal & septal disruption), Type V is associated with NEO fracture and midface fracture. and then we did follow up after correction and estimate the incidence of secondary deformity in classification of nasal bone fracture. The follow-up period of patients ranged from 3 months to 5 years with a mean of 2.7 years. The results were as follow. First, in Type I, II, IV, the rate of incidence of depression and hump formation after operation was lower than in Type III, V. Second, in Type III, the rate of incidence of depression and hump formation was higher than in type IV, because we had corrected nasal bone fracture with more aggressive approach in Type IV. Third, in Type IV, the rate of incidence of deviation was highest due to septal disruption. Forth, in Type V, the rate of incidence of depression and hump formation was the highest, but the rate of incidence of deviation was lower than that in Type IV. Fifth, it was highest rate of incidence of deviation of C-shape nasal bone fracture preoperatively and C-shape deformity postoperatively in type IV. Sixth, a deviated shape of nasal bone fracture was tend to be the same deviated shape of secondary deformity and It's tendency was higher in S-shape nasal bone fracture in Type IV. Seventh, it was considered that the more accurate reduction of nasal bone fracture by open approach was advisable in severe cases to reduce the incidence of postoperative secondary deformity.