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Differential Diagnosis

  • Fractures of the nasal bone and anterior nasal spine
  • Fracture of the orbit and zygoma
  • Nasal soft tissue injury
Fractures of the nasal bone and anterior nasal spine
Image Provided by Experity Teleradiology

Diagnosis

The correct diagnosis in this case is fractures of the nasal bone and anterior nasal spine. As seen in the x-ray, there is a linear fracture through the nasal bone. Irregularity of the anterior nasal spine with overlying soft tissue swelling can be observed.

What to Look For

  • Fractures of the anterior nasal spine in maxillofacial trauma are common, and missed diagnosis of these types of fractures happens often because the structure can be overlooked in evaluations
  • Evaluate for other fractures of the facial bones
  • It is important to evaluate for septal hematoma as this requires intervention to prevent necrosis and infection

Pearls for Urgent Care Management

  • Initial treatment includes ice, oral pain medications, and head elevation
  • For displaced fractures, discuss with a specialist about preferred timing of reduction

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