What is the Protocol for Fixing Newly Broken Nose?

The first thing is to be seen in the Emergency Room or by an ENT/Facial Plastic Surgeon to ensure there is no septal hematoma (i.e. blood trapped underneath the mucosa covering your septal cartilage).  If not diagnosed early, the cartilage will be without a blood supply resulting it dying/absorbing and the bridge collapsed.  This is an easy issue to address, but needs to be diagnosed early i.e. within the first 1-2 days after the injury.

Next is to be seen by an ENT/Facial Plastic Surgeon approximately one week after the trauma.  The reason is that a fractured nose is a clinical diagnosis (i.e. does it look crooked, off center, depressed, etc.) This can’t be determined for 7 days because of the swelling.  Swelling will fool the best of eyes the first week.  X-rays are of NO value in determining a fracture.  If a fracture line is seen on the X-ray, it still can’t tell the surgeon if that is a current fracture, or one from years ago.  The x-ray doesn’t tell the timing, and a CT is the same.

If it is determined that there has been a recent trauma, typically the surgeon will want to perform a closed nasal reduction within the 7-10 day period after the trauma.  During this time frame the swelling is gone, and the bones are now becoming “sticky” as they are starting to heal.  Typically, the patient is taken to the operating room for a very brief (10-15 min) anesthetic, during which time the bones are moved back into their previous anatomic state, absorb-able gauze is placed beneath the nasal bone and a metal splint is placed on the outside to help stabilize the bone to heal in the correct position.

Should the above closed nasal reduction not be successful, the patient is then taken back to the operating room at 6 weeks or any time thereafter to formally re-fracture the nose in a much more controlled manner using osteotomies (similar to delicate chisels) and then properly set with a splint.

Hope you found this answer helpful.  All the best!

If the result of your broken nose is a crooked appearance, the nasal skeleton may be repositioned to appear straighter. The key is to be evaluated by a reputable rhinoplasty specialist within the first two weeks following the trauma before the nasal skeleton heals and becomes fixated. Some nasal fractures are severe and surgical intervention may be warranted. Post-traumatic nasal surgery may be performed after all nasal and facial swelling has dissipated.Hope this helps.Dr Joseph

Nasal fractures occur frequently following facial
trauma.When patients have obvious or
displaced nasal fractures, they will usually require corrective surgery.Not all nasal fractures require treatment.In some cases, the bones and cartilage aren’t
displaced and because of this, surgery isn’t indicated.When
corrective surgery is performed within three weeks of the fracture, closed
nasal reduction is performed.This is a
relatively simple procedure that re-positions and stabilizes the nasal
bones.If repair isn’t done within three
weeks of injury, corrections need to be delayed for one year and then a formal
rhinoplasty performed.