Published in:
01-02-2016 | Original Paper
Outcomes following manipulation of nasal fractures—the Durham experience
Published in: European Journal of Plastic Surgery | Issue 1/2016
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Background
Early manipulation of nasal fractures can negate the need for formal rhinoplasty. However, residual nasal deformity is reported in up to 50 % of cases. The aim of this study was to evaluate the outcome following manipulation of nasal fractures in a regional plastic surgery department and quantify the subsequent rhinoplasty conversion rate.
Methods
A retrospective review of all patients presenting with nasal fractures who had undergone manipulation under anaesthetic (MUA) in a single plastic surgery unit over a 7-year period was performed.
Results
Three hundred fifty-three MUA procedures were performed, the majority of which were in young males (76 %). Common causes included assault (54 %), sporting injuries (24 %) and falls (12 %). MUA was performed for nasal bone fracture (69 %) or bony and septal fracture (31 %). Only 37 % (130 patients) attended outpatient follow-up. Functional problems were identified in 17 % (22 patients), whilst 24 % (31 patients) noted residual deformity. Of these, 10 patients (3 %) accepted and underwent formal rhinoplasty surgery. This accounted for 17 % of all rhinoplasties carried out within the time period.
Conclusions
In our department, the outcome following manipulation of these injuries compares favourably with the literature, with the majority of patients having no major long-term sequelae. Our data suggest that many patients are happy to accept a degree of residual deformity and decline further surgery.
Level of Evidence: Level IV, risk / prognostic study