Possible broken nose during the game, including sports, during a crash, and in the fight in the fall. But sometimes it's hard to say whether his nose is broken. When you hit the nose is swollen and appears curved, even if there is no fracture. When a few days later the swelling subsides, it is much easier to determine if the nose is broken.

Symptoms

• Pain in the nose
• Edema
• The nose seems to be bent and twisted
• Bruise around the nose or eyes
• Mucous discharge or bleeding from the nose
• The rattle or scraping feeling when you try to touch your nose or rub it
• Overlapped nasal passages

The possible complications of nose fracture include:

• Nose or tip of the nose remains crooked.
• For nasal septum accumulate a large amount of blood (hematoma of the nasal partition).
• The hole in the nasal septum (nasal septum perforation) or broken bridge (saddle nose deformity).
• Twisted (offset) nasal septum. The nasal septum - a structure that divides the nose into two parts
• Heavy breathing
• Constant mucus Mucus - what is the norm for a healthy woman   one or both nostrils. This may be the result of leakage of cerebrospinal fluid (cerebrospinal fluid rhinorrhea) after receiving traumatic brain injury or after surgery nose or ear.
• Infection of the mucosa of the nose, sinuses or facial bones.
• Changes in the perception of smell or anosmia.

Diagnostics

The diagnosis of "broken nose" is placed after the physical examination and analysis of medical records. Chest X-ray for diagnosis is not usually required. If there is suspicion of damage to or in front of the facial bones of the skull, carried out computer tomography. The doctor may delay the examination of a few days until the swelling subsides.

Treatment

Immediately upon receipt of the damage must be applied to the affected area and ice to keep his head thrown back up. Sometimes you need to receive pain medication, such as acetaminophen (eg, Tylenol). Within 48 hours after the trauma of the nose should not take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen Ibuprofen: anti-inflammatory drug   (Advil or Motrin) and aspirin. In no event should not take aspirin to anyone under the age of twenty years, since in this case there is a high risk of developing Reye's syndrome.

In some complications that occur after a fracture of the nose requires immediate treatment to the doctor:

• For nasal septum accumulate a large amount of blood (hematoma of the nasal partition).
• Bleeding that does not work to stop (epistaxis).
• Transparent liquid, coming from one or both nostrils (cerebrospinal fluid rhinorrhea)

Treatment of fracture of the nose lasts from seven to fourteen days. In most cases, special treatment is limited to taking pain and other symptoms of fracture reduction.

• The doctor may conduct a simple fracture treatment by straightening the bent bone or cartilage of the nasal septum. Also, it is sometimes necessary splinting or pack the nose with the help of gauze.
• For the treatment of more complex fractures can be performed surgery. This is done in those cases when it is required to return to a displacement of bone or cartilage. Can I require splinting or plugging nose. To prevent infection, the patient is prescribed antibiotics Antibiotics - whether they will help you in the foreseeable future? . After 48-72 hours, after re-evaluation, the tampon How to use sanitary pad - basic precautions   removed.

The idea of ​​connecting the broken bones surgically greatly accelerated the process of treatment and rehabilitation of patients with open fractures and complicated. The first operations on the connection of bone fragments have been started in the 19th century, but then they stopped doing because of the emergence of serious suppurative complications. These operations were resumed only after the introduction of the practice aseptic and antiseptic.

What is the fixation and its species

Osteosynthesis task force called bone fragments. It is used in the treatment of fresh ununited wrong accrete fracture and pseudoarthrosis False joints - when the mobility of broken bones . The purpose of osteosynthesis - to provide fixation of bone fragments mapped, creating conditions for their bone fusion, restore the integrity and function of a limb.

There are two basic types of osteosynthesis - immersion (injection directly into bone fastener fracture zone) and outer (extrafocal) - by means of spokes conducted in fragments through the skin and fixed to any apparatus. For the connection of small bone fragments, and more to connect the transplant of bone grafts, used ultrasound osteosynthesis.

Osteosynthesis is intraosseous, and extramedullary transosseus. To perform osteosynthesis use different tabs for intraosseous - pins and nails for extramedullary - plate with screws to transosseous - bolts and spokes. Often used a combination of several kinds of osteosynthesis. All clamps for osteosynthesis should be made of biologically, chemically and physically inert (neutral) materials. As a rule, used metal structures made of stainless steel, vitalliya, titanium, sometimes made of bone and inert plastics. Metal clamps after fracture healing is usually removed. Some locks are a combination of extramedullary and intraosseous structures.

Submersible intraosseous osteosynthesis

Submersible intramedullary fixation can be open and closed. When closed osteosynthesis after comparing fragments with the help of special devices in the medullary canal of the fractured bone through a wire through a small incision away from the fracture site is administered under the control of the X-diameter long metal hollow rod. The conductor is removed and the wound was sutured.

With an open osteosynthesis, which is used more often expose the fracture zone, fragments are compared in the medullary canal of the fractured bone is introduced mechanical rod. Outdoor fixation does not require special equipment to map the fragments, it is technically easier and more affordable closed, however, with the closed method of fracture zone is not exposed, reducing the risk of infection, less damaged soft tissue around the bone fragments.

Submersible osteosynthesis

Submersible osteosynthesis used in fractures of various localization and type (comminuted, oblique, helical, lateral, periarticular, intraarticular), regardless of the shape and bend the medullary canal. Most of the catches for osteosynthesis are of different shapes and thickness of the plate is connected to the bone with screws. Many modern plate have special bringing together the device, including fixed and removable. After osteosynthesis often impose additional plaster cast.

Osteosynthesis with helical oblique fractures and may be formed by a metal wire, metal strips, the special half-rings and rings of stainless steel. This type of osteosynthesis, particularly the wire, as an independent method is rarely used because of inadequate solid fixation, usually it is in addition to other types of osteosynthesis.

Osteosynthesis soft suture material (catgut, silk, polyester) is rarely used, as the thread can not withstand the thrust and muscle re-displacement of fragments.

Submersible transosseous osteosynthesis

Submersible transosseous osteosynthesis is carried out by means of screws, bolts, spokes. When this is carried out in the transverse clamps or kosopoperechnom direction through the wall of the tube in the area of ​​bone fracture. A special kind of transosseous osteosynthesis is a bone joint. In the fragments of drilled channels and through them spend ligatures (silk, catgut, wire), which are then tightened and tie. Bone suture used for fractures of the patella, olecranon. When transosseous osteosynthesis, usually impose a plaster cast.

External fixation

External fixation is carried out by means of special devices (by Ilizarov, Volkov-Oganesyan). It allows you to not exposing the fracture site, and compare the fragments firmly to fix them. The method does not require plaster immobilization, patients with the devices in the lower extremities can go with a full load.

Complications of osteosynthesis

Complications during osteosynthesis can cause the wrong choice of method of fixation of bone fragments, wrongly chosen type of fastener failure to stability mapped fragments, lack of respect for aseptic and antiseptic, ill-treatment of soft tissue. All of these can cause abnormal fracture healing, nonunion, or it fester.

Submersible osteosynthesis long massive plates accompanied by the exposure of the bone over a large area, which violates its food (blood flow), and may be the cause of slow accretion. Remaining after the removal of screws numerous holes weaken bone.

Nailing - is the most modern method of treatment of fractures.

Galina Romanenko