📝 “What is Closed Reduction of Bilateral Nasal Bone Fractures?”

8.26.24

Quick Review #214 - #surgery #surgeon #doctorgallagher #oralsurgery #oralsurgeon #omfs #dentist #dentistry #dental #closedreduction #nasalbone #fracture #nasalbonefracture

Closed Reduction of Bilateral Nasal Bone Fractures is a common treatment for nasal bone fractures, particularly when there is no severe comminution or displacement that requires open surgical intervention:

Indications:

1. Non-Comminuted Fractures: Appropriate for fractures without extensive comminution or with minimal displacement.

2. Cosmetic Deformity: Used when there is external nasal deformity or deviation needing correction.

3. Nasal Obstruction: Indicated if the fracture causes significant nasal airway obstruction.

4. Timing: Best performed within 7-10 days after injury, before significant callus formation.

5. Patient Preference: Chosen when the patient prefers a less invasive procedure and accepts potential minor residual deformity.

Advantages:

1. Minimally Invasive: Avoids surgical incisions, reducing infection risk and scarring.

2. Shorter Recovery: Patients typically recover faster with less downtime than with open reduction.

3. Outpatient Procedure: Often done under local anesthesia, reducing hospital stay and costs.

4. Reduced Morbidity: Lower risk of complications such as infection, septal perforation, and external scarring.

5. Cost-Effective: Lower overall cost due to reduced operative time, anesthesia, and hospital resources.

Techniques & Instruments:

1. Digital Manipulation:

• Uses fingers to manually realign the nasal bones.

• Pressure is applied to move the bones back into position.

2. Asch Forceps: Used to elevate depressed nasal bones by inserting forceps into the nasal cavity and prying fractured segments into alignment.

3. Walsham Forceps: Grabs and manipulates the nasal bones externally. The forceps are applied over the nasal bridge, and bones are maneuvered back into place.

4. Boies Elevator: Elevates depressed nasal bone fragments. The elevator is placed inside the nasal cavity to lift segments into alignment.

5. External Splinting: An external splint (e.g., thermoplastic or aluminum) is applied post-reduction to maintain bone position. Internal splints or nasal packing may also be used.

6. Nasal Packing: Supports the realigned bones internally, with packs placed inside the nasal cavity to maintain position and reduce swelling and bleeding.

References:

1. Fusetti, S., Cornelius, C.-P., Gellrich, N., Hillerup, S., Kusumoto, K., & Schubert, W. (n.d.). Closed reduction: Nasal bone. AO Surgery Reference.

2. Kocak, A., & Yucesoy, C. A. (2019). Management of nasal bone fractures. Plastic Surgery, 5(1), 32-39.

3. Rohrich, R. J., Adams, W. P., & Gunter, J. P. (2000). Nasal fractures: The role of closed and open reduction. Plastic and Reconstructive Surgery, 106(5), 942-949.

4. ChatGPT.2024

#podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentistry #oralsurgery #dental #viral #dentalschool #dentalstudent #omfs #surgeon #doctorlife #dentistlife #residency #oralsurgeon #dentist #doctorgallagher