Convex bone deformity after closed reduction of nasal bone fracture

Abstract

Background: Nasal fracture is the most common type of facial fracture treated by plastic surgeons. Here, we clarify the postoperative deformities that frequently remain after closed reduction of fresh nasal bone fracture by three-dimensional computed tomography (3D-CT).

Methods: Hundred consecutive cases of fresh nasal bone fracture in patients treated between May 2010 and January 2016 were examined. After closed reduction, the overall appearance of the arch formed by the nasal bone and maxillary process was evaluated as 'Excellent', 'Good' or 'Fair'. Patients were also asked about their overall satisfaction with the operation, and the responses were classified as 'Satisfied', 'Neutral' or 'Dissatisfied'.

Results: Eighty-six patients underwent 3D-CT examination both at the time of the initial consultation and 3 months after the operation. The results were 'Excellent' in 69 patients and 'Good' in 17 patients, with none of the patients having only 'Fair' results. Convex bone deformities on one side were seen in all six bilateral type fractures evaluated as 'Good'. All patients classified as 'Excellent' reported being 'Satisfied' with the results, but some patients classified as 'Good' gave a 'Neutral' evaluation regarding their satisfaction.

Conclusions: The residual deformities seen in bilateral type fractures were most notable, and they were all convex bone deformities on one side. Plastic surgeons should use ultrasonography or other reliable new methods in addition to visual inspection during the operation to successfully treat the region of the convex fracture.

Keywords: Bilateral fracture type; Convex bone deformity; Facial bone fracture; Nasal fracture; Secondary nasal deformity.