10 Year Old Bicycle Accident and Possibly has Broken Nose, Should I wait Until Swelling Goes Down to Take Him in?

My son was in a bicycle accident on Saturday and I am pretty sure he broke his nose. There was a TON of blood and swelling started immediately. I am now (its now Monday) becoming concerned that maybe he fractured something else in his face. His left eye is almost swollen shut and black all over his left side of face. Should I wait to take him until the swelling es down or shoud I take him right away? Any advice would be greatly appreciated!

Doctor Answers (8)

Should I have my son evaluated

+1

I would take your son in for an evaluation as soon as possible. You will likely need to go the ER for a workup. Part of the workup will likely involve a maxilofacial CT scan. If the scan reveals fractures you will likely be referred to a facial plastic surgeon. Depending on the severity of the fracture, it is possible to reduce a nasal fracture simply by shifting the nasal bones back into the midline and putting a cast on it. This can be done if the fracture is simple and if it is performed within about 10 days of the accident. The most important thing is to get it evaluated as soon as possible.


Orange County Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Facial injury

+1

He should be medically evaluated and ideally should get a CT scan of the face to look for possible facial fractures.  If the nose is fractured but not displaced there is no emergent need for surgery

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 137 reviews

Bike accident

+1

I would take him either to a plastic surgeon or the emergency room.  It sounds like he may have other facial injuries, and he would probable a CAT scan done.   If you take him to the ER, they will be able to get a Cat scan right away and notify a plastic surgeon regarding any fractures other than the nasal fracture.  From your description he needs a CAT scan done anyway, so it makes the most sense to be evaluated first in an ER, get the CAT scan, then be referred to a plastic surgeon if necessary.

 

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 8 reviews

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When should you seek a plastic surgeon following facial injury?

+1

When should you seek a plastic surgeon following facial injury? Although it has only been a few days and the swelling is still significant, I would recommend seeking a facial trauma surgeon (Facial Plastic Surgeon, Plastic Surgeon, Oculoplastic Surgeon) for evaluation. It is possible that there is only soft tissue trauma and swelling but an in person consultation will determine if there is any bony injury. Your son might require imaging (CT scan) based on that evaluation. If there are facial fractures, most should be fixed within two weeks. Also if there is a nasal fracture it can be "reduced" in the office with a small amount of sedation within a two week window. If the fracture heals it will require a surgical procedure to repair which is obviously much more invasive with more downtime. For these reasons, your son should be seen sooner rather than later.

Thank you for your question.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
5.0 out of 5 stars 36 reviews

Depending on your insurance, you may want to start with your pediatrician

+1

From your description, I agree with all the other comments that you should take him for evaluation.

  • If the mechanism of injury caused that much bruising and bleeding, he should see a facial plastic surgeon or plastic surgeon this week.  
  • His pediatrician could order a CT scan before the surgery consult. 

Best Wishes

Travis T. Tollefson, MD, MPH
Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Don't wait

+1

If the nose is broken and needs to be set, it needs to be done within the first 3 weeks. Don't wait any more = go see a plastic surgeon

William B. Rosenblatt, MD
New York Plastic Surgeon
4.0 out of 5 stars 9 reviews

If a broken nose is suspected, the patient should be seen as soon as possible.

+1

If the nasal bones are displaced from a fracture, as time passes they will become secure in their new (and unwanted) location.  Before this occurs, the surgeon can manipulate the bones closer to their original location to minimize any cosmetic deformity. 

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

Possible nasal fracture

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After an accident with your description of events you should have a full evaluation and diagnosis. In these incidents there may be a case of a tri malar fracture or orbital floor fracture which would be diagnosed via radiographic evaluation. Whenever a facial or head injury has incurred it is best to be safe then sorry. Take your son in for full evaluation and then hopefully you will have some peace of mind. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 127 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.