Definition

A nose fracture is a break in the bone or cartilage over the bridge, or in the sidewall or septum (structure that divides the nostrils) of the nose.

Alternative Names

Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture 

Considerations

A fractured nose is the most common fracture of the face. It most often occurs after an injury and often occurs with other fractures of the face.

Nose injuries and neck injuries are often seen together. A blow that is forceful enough to injure the nose may be hard enough to injure the neck.

Serious nose injuries cause problems that need a health care provider's attention right away. For example, damage to the cartilage can cause a collection of blood to form inside the nose. If this blood is not drained right away, it can cause an abscess or a permanent deformity that blocks the nose. It may lead to tissue death and cause the nose to collapse.

For minor nose injuries, the provider may want to see the person within the first week after the injury to see if the nose has moved out of its normal shape.

Sometimes, surgery may be needed to correct a nose or septum that has been bent out of shape by an injury. A doctor may be able to return nasal bones that have moved out of place back to their normal position within the first 2 weeks after the break.

Symptoms

Symptoms may include:

• Blood coming from the nose
• Bruising around the eyes
• Difficulty breathing through the nose
• Misshapen appearance (may not be apparent until the swelling goes down)
• Pain
• Swelling

The bruised appearance most often disappears after 2 weeks.

First Aid

If a nose injury happens:

• Try to stay calm.
• Breathe through your mouth and lean forward in a sitting position to keep blood from going down the back of your throat.
• Squeeze the nostrils closed and hold pressure to stop the bleeding.
• Apply cold compresses to your nose to reduce swelling. If possible, hold the compress so that there isn't too much pressure on the nose.
• To help relieve pain, try acetaminophen (Tylenol).

Do Not

If a nose injury happens or if someone may have a broken nose:

• DO NOT try to straighten a broken nose.
• DO NOT move the person if there is reason to suspect a head or neck injury.

When to Contact a Medical Professional

Get medical help right away if:

• Bleeding does not stop
• Clear fluid keeps draining from the nose
• You suspect a blood clot in the septum
• You suspect a neck or head injury
• The nose looks deformed or out of its usual shape
• The person is having difficulty breathing

Prevention

Wear protective headgear while playing contact sports, or riding bicycles, skateboards, roller skates, or rollerblades.

Use seat belts and appropriate car seats when driving.

References

Chegar BE, Tatum SA. Nasal fractures. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 30.

Kim L, Huddle MG, Smith RM, Byrne P. Nasal fractures. In: Dorafshar AH, Rodriguez ED, Manson PN, eds. Facial Trauma Surgery. Philadelphia, PA: Elsevier; 2020:chap 1.10.

Mayersak RJ. Facial trauma. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 34.

Rodriguez ED, Dorafshar AH, Manson PN. Facial injuries. In: Rodriguez ED, Losee JE, Neligan PC, eds. Plastic Surgery: Volume 3: Craniofacial, Head and Neck Surgery and Pediatric Plastic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 3.