For physicians covering hockey and wrestling, evaluation of facial injuries are commonplace.
For physicians covering hockey and wrestling, evaluation of facial injuries are commonplace. Facial fractures are common injuries and account for 400,000 annual visits to the ER annually in the US. Due to severe side effects of a septal hematoma, having a strong working knowledge of these injuries is a must.
Case You are covering a wrestling tournament and one of the athletes is brought to the tent after being elbowed in the nose by an opposing player. Which of the following complications of a nasal fracture can lead to septal necrosis? A) Septal hematoma B) Superficial laceration C) Comminuted nasal bone fracture D) Nasal deviation Anatomy In order to make the diagnosis of a nasal fracture, it is important to be aware of the anatomy that make up the nasal complex.
The bony anatomy involves bones from the maxilla, ethmoid bone, frontal bone, vomer, and nasal bones. The nasal bones are paired bones that join each other at the midline. Fractures will most commonly occur at the distal end of the nasal bones.
As seen in The nasal cartilage consists of the upper and lower lateral cartilages and the midline septum. It is less common to fracture the nasal cartilage than the nasal bone and septum. Physical Exam Symptoms suggestive of a nasal bone fracture are epistaxis, swelling, and bruising.
The physical exam starts with examination of the external structures. Providers should evaluate for nasal malposition, lacerations, and periorbital swelling. The physical exam also involves palpation for crepitus, tenderness, and depression of the nasal bones.
If you are experiencing symptoms that may be related to nasal fractures, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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