Is my daughters nose broke despite the x-rays coming back negative?

You should be examined by a surgeon to determine how to manage the nose.Kenneth Hughes, MDLos Angeles, CA

Yes, it should be re-evaluated. A negative imaging study doesn't guarantee that you don't have a fracture. Also, repairing it soon makes the surgery A LOT easier than allowing the fracture to heal in an undesireable form.

If the nose looks displaced with a bump or off-center and looks different than before the accident, it is likely fractured. X-rays amy miss it, and cartilage fractures do not project on x-rays too well if at all.

Even though the nasal bones do not appear fractured on the x-ray, cartilage can become fractured and displaced away from the bones themselves. Cartilage grafting such as a spreader graft may be required if the upper lateral cartilage has been fractured off the nasal bone. It is best to have this done within the first month after the injury, rather than waiting for it to heal crooked. For many examples please see the link below

An x-ray is typically not needed to diagnose a broken nose. Go see a plastic surgeon or facial plastic surgeon as soon as possible for an evaluation. The bones may not be broken but the cartilage may be damaged and cause the nose to look bent to one side - this will not show up on an x-ray. If you wait too long, it is harder to fix and get insurance to cover it.

If your daughter's nose looks different than it did before the accident or breathing is obstructed after the swelling resolves, it is broken. Broken cartilage does not show up on routine x-rays; your physician's examination is much more reliable.