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Fracture of bones of a nose
The fracture of bones of a nose is an injury which happens rather often: in general among injuries of the person the fracture of a nose makes 40% of cases. A basic reason owing to which there is such change is the direct injury. So, very often the fracture of a nose happens at athletes, and also similar occurs as a result of fights, serious falling, road accidents.
Reasons of a fracture of bones of a nose
The fracture of bones of a nose meets very often, first of all, owing to an anatomic structure of a human face. The nose is the most outstanding part of the face. Therefore, it is also exposed to injuries in case of a number of situations. Most often the fracture of bones of a nose occurs at people who participated in a fight, got certain sports injuries (group sports, boxing, fight), had car accidents. The change can also arise as an effect of falling or direct strokes about a firm subject.
Symptoms of a fracture of bones of a nose
Symptoms and character of a fracture of nose directly depends on that how strong and directed was blow, and also what subject became the reason traumatized. Also that fact what the nose design at the specific person is is not less important: if the nose very large and outstanding forward, then it can suffer at an injury much stronger, than a nose flat which bone, as a rule, thicker.
If the slight injury of bone part of a nose took place, then not always noticeable deformations can be a change consequence. Sometimes the similar change is found only during a X-ray.
Most often owing to a nose injury the person has his laterposition. As physicians note, more often the nose is displaced to the right side that is explained by character of the received blows in a fight: they are generally put in the left part of a nose with the right hand.
At the same time, if the blow was struck from top to down, then the nose in this case is protected by a frontal bone. Therefore, such blow affects the lower, brittle part of a nose. In this case there can be a cross fracture of nasal bones, and in certain cases and frontal shoots.
The cartilaginous part of a nose is more elastic therefore can often have injuries more considerable and serious. However at some injuries there is a crack of a quadrangular cartilage, at the same time the hematoma is often formed.
Defining nose fracture symptoms, it is necessary to pay initially attention to classification of such changes which is applied in the medical environment. Changes can be subdivided into the closed and open fracture of a nose without the shift of bone fragments and deformation of an outside nose, and also into the closed and open fracture of a nose with the shift of bone fragments and deformation of an outside nose. Besides, owing to injuries damage of a nasal partition can take place.
Very often at a change there is a separation of bones of a nose on bone seams. If the injury was very strong, then the bone department can be completely flattened out, at the same time bones of a nose sink down.
The person who got a nose fracture at once after such injury has some characteristic symptoms. At once after incident of the patient stays in the state of shock expressed in different degree. Also emergence of nasal bleedings is characteristic of such state. As a rule, such bleedings happen moderate, and stop independently. At palpation of a nose of people in case of a change feels severe pain, at the same time from a nose there are mucous allocations.
In nose covers, and also near a century and a malar the expressed extensive bruises are shown. Often also hemorrhages in a conjunctiva of eyes and a century take place. As a symptom of a fracture of nose hypodermic air emphysema is sometimes formed. However in this case it is about a fracture of bones of a nose at which there is a rupture of a mucous membrane of a nose. As a rule, in several days emphysema passes independently. At a fracture of bones of a nose integrity of skin can be also broken, be deformed an outside nose.
As a rule, for the second day after receiving such injury hypostases on outside covers develop, the mucous membrane bulks up. Provided that the infection does not join development of a disease, hypostases pass independently several days later. In this case it is reasonable to apply cold lotions, to put ice for process acceleration.
At the same time at accession of an infection at the patient other symptoms are shown already. Pain and reddening can be shown on all nose, at the person at the same time body temperature sharply increases. Abscess which or is opened independently is sometimes shown, or it should be opened in the surgical way.
If in time all measures for treatment of this injury were not taken, then further the patient has a deformation of an outside nose. Emergence of a hematoma of a partition of a nose is also possible. As the effect of deformation of a nose is possible manifestation of disorders of nasal breath, and also disturbances of sense of smell. Constant headaches, asthma attacks, an epileptiform neuralgia can be the subsequent complications of such state.
In case of the closed fracture of a nose there is no disturbance of integrity of skin. At the same time at an open change also skin is injured. In this case in a wound visible particles of a bone can be found.
Diagnosis of a fracture of bones of a nose
In the course of diagnosis of a fracture of bones of a nose poll of the patient as the doctor needs to learn is considered an important point, how exactly the patient was traumatized. Then the specialist examines a nose and feels it. In the course of palpation the weak crunch can be felt, and the patient always feels pain. In the course of establishment of the diagnosis inspection of a nasal cavity which is called a rinoskopiya is also performed. In order that the patient had no strong unpleasant feelings, before carrying out such research to it, as a rule, do anesthesia. For this purpose ten-percentage solution of lidocaine is often used. One more possible method of research in this case is a carrying out endoscopy. Such procedure provides introduction to a nasal cavity of the flexible thin tube equipped on the end with illumination and a video camera.
Also in the course of diagnosis of a fracture of nose the X-ray analysis is sometimes applied: the roentgenogram of bones of a nose is made in a lateral projection.
Complications of a fracture of bones of a nose
Owing to a fracture of bones of a nose at the person so unpleasant complication as a nose partition curvature can be shown later. Breath disturbance by a nose on the one hand can become an effect of such pathology. Therefore the person who has such disturbance can have chronic sinusitis or rhinitis as a result. To get rid of such complication, surgical intervention is necessary.
Very often an effect of a difficult fracture of nose is emergence of a small hump on a nose, its asymmetry. In that case many patients decide on carrying out plastic surgical correction.
If the person had a nose fracture to shift, then breath disturbance by a nose can be very serious, up to its full blocking.
Also as complications the nose cartilage fracture is possible that it happens if the person during getting injured hit against a firm subject, and at the same time the blow was direct.
In certain cases the fracture of bones of a nose can be combined with a nose partition hematoma. At such diagnosis there is accumulation of blood under a mucous membrane. Besides, the hematoma negatively influences breath by a nose, closing the nasal courses. Such pathology is eliminated in the surgical way.
Treatment of a fracture of bones of a nose
At once after receiving a fracture of bones of a nose the person should not lift up the head too highly. It is desirable to incline a little it sideways and to try to stop bleeding. After an injury at suspicion on existence of a fracture of bones of a nose it is necessary, without postponing, to put cold to the area of a nose. Similar actions can prevent developing of severe hypostases, and in certain cases and help to stop the bleeding which is permanently arising at a fracture of bones of a nose.
Treatment of a fracture of nose is carried out differently, depending on what character of a change took place. It is very important that necessary therapy was carried out as soon as possible therefore the main rule of treatment of a fracture of nose is providing the operational address to specialists. If at a nose injury at the patient severe bleeding takes place, then the doctor, first of all, stops a wound by means of insertion of tampons which become impregnated with special solutions. In the presence of pollution preprocessing of a wound is carried out
If the injury which led to a change occurred no more than ten days ago, then the doctor can apply the closed change reposition. The essence of such procedure consists in manual installation of bones into place. For carrying out procedure mainly local anesthesia and special tools is used. Anesthesia is made by means of an irrigation of a mucous membrane of a nose by anesthetic, at the same time the injection of the anesthetizing drug under skin is outwardly made. In certain cases the doctor manages to run reposition by means of several movements by fingers. However at retraction of a bone the tool which is called an elevator is used. It is entered into a nasal cavity and lift the sunk-down part of a bone with its help. After such procedure insert tampons which impregnate previously with an antibiotic into a nose to provide hard pressing. Such tampons are in a nasal cavity several days. Sometimes the special compressing bandage is applied to fixing of the set nose.
Making the decision on reposition of a fracture of nose, the doctor surely considers age of the patient, feature of his constitution, character of a change. However each person, the victim of an injury and the received fracture of bones of a nose, has to realize that independently it is impossible to conduct reposition of bones categorically. There is a big risk of receiving an additional injury.
If treatment of a fracture of nose is carried out to later terms, then purpose of carrying out a surgery – rhinoplasty is in that case possible. Such operation is sometimes appointed also in the presence of esthetic problems after reposition of a change. Sometimes in parallel the doctor also carries out recovery of nasal breath, correcting the bent nasal partition. If such actions are necessary, then will already go to the speech about carrying out more difficult operation — rinoseptoplastik. Both the plastic surgeon, and the LOR-specialist can carry out this surgical intervention.
After the end of surgery apply a plaster bandage for fixing which it is necessary to carry about two weeks a nose.
Section: Diseases of an ear throat-nose