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Early management of displaced nasal fractures
  1. Terry Gilpin,
  2. Simon Carley
  1. Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL

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    Report by Terry Gilpin, Specialist Registrar Search checked by Simon Carley, Specialist Registrar

    Clinical scenario

    A 27 year old man attends the emergency department having been involved in a fight. He had been hit on the nose and has an obvious displaced nasal fracture without septal haematoma. As yet there is no gross swelling. You wonder whether immediate reduction would be better than delayed reduction.

    Three part question

    In [adults with displaced nasal fractures without gross swelling] is [early reduction better than late reduction] at [optimising functional and cosmetic recovery]?

    Search strategy

    Medline 1966–03/00 using the OVID interface. ({exp nose OR exp nose deformities, acquired OR nose.mp} AND {exp fractures OR fracture.mp}) AND maximally sensitive RCT filter LIMIT to human AND english.

    Search outcome

    Altogether 104 papers were found of which none were relevant.

    Comments

    There is no direct evidence that can assist in answering this question.

    Clinical bottom line

    Local advice should be followed.

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