Long-term postoperative satisfaction and complications in nasal bone fracture patients according to fracture type, site, and severity

Abstract

Background: It is difficult to completely fix nasal bone fractures with closed reduction, as it is often accompanied by septal cartilage damage, and this often results in postoperative secondary deformities. Thus, patients are often reluctant to undergo closed reduction surgery. The present study aimed to evaluate aesthetic and functional satisfaction, as well as satisfaction with and complications of closed reduction, according to nasal bone fracture type.

Methods: The subjects were patients who underwent closed reduction under general anesthesia from January 2017 to December 2018. Based on the modified Murray classification, patients were classified into five groups according to the fracture site, septal fracture, and deviation. A total of 211 patients were sent a web-based survey on postoperative satisfaction and complications, as well as intention for revision and cosmetic surgery. Sixty-one patients (28.9%) responded.

Results: There were no significant differences in aesthetic and functional satisfaction or satisfaction with closed reduction according to the fracture type, site, or severity. Postoperative functional complications developed in 14 of 61 patients (22.95%). With 10 out of 24 (41.67%) patients (p = 0.044), the bilateral fracture with septal fracture or prominent septal deviation type had a higher incidence of complications than the other types.

Conclusion: The incidence of complications is higher for bilateral fracture with septal fracture or prominent septal deviation compared to the other nasal bone fracture types. Therefore, long-term follow-up after closed reduction surgery for this fracture type can aid in establishing additional postoperative treatment plans and improving patient satisfaction.

Keywords: Bone fractures; Closed fracture reduction; Esthetics; Nasal bone; Postoperative complications.

Fig. 1.

Patient classification. (A) Am, unilateral fracture without septal fracture or prominent septal deviation. (B) As, unilateral fracture with septal fracture or prominent septal deviation. (C) Bm, bilateral fracture without septal fracture or prominent septal deviation. (D) Bs, bilateral fracture with septal fracture or prominent septal deviation. (E) C, comminuted fracture.

Fig. 2.

Study group selection flowchart. Am, unilateral fracture without septal fracture or prominent septal deviation; As, unilateral fracture with septal fracture or prominent septal deviation; Bm, bilateral fracture without septal fracture or prominent septal deviation; Bs, bilateral fracture with septal fracture or prominent septal deviation; C, comminuted fracture.

Fig. 3.

(A, B) Injury type of nasal bone fracture according to fracture type. Am, unilateral fracture without septal fracture or prominent septal deviation; As, unilateral fracture with septal fracture or prominent septal deviation; Bm, bilateral fracture without septal fracture or prominent septal deviation; Bs, bilateral fracture with septal fracture or prominent septal deviation; C, comminuted fracture.

Fig. 4.

(A) Aesthetic complication rate according to fracture type. (B) Functional complication rate according to fracture type. Am, unilateral fracture without septal fracture or prominent septal deviation; As, unilateral fracture with septal fracture or prominent septal deviation; Bm, bilateral fracture without septal fracture or prominent septal deviation; Bs, bilateral fracture with septal fracture or prominent septal deviation; C, comminuted fracture.