A Single Center Review of Pediatric Nasal Bone Fractures - An Analysis of Concomitant Injuries, Management, and Outcomes

Meher Pandher; Thayer J Mukherjee; Jordan N Halsey; Margaret M Luthringer; Roman Povolotskiy; Ian C Hoppe; Mark S Granick

A Single Center Review of Pediatric Nasal Bone Fractures - An Analysis of Concomitant Injuries, Management, and Outcomes

Eplasty. 2021 Aug 18:21:e4. eCollection 2021.

Authors

Meher Pandher¹, Thayer J Mukherjee¹, Jordan N Halsey¹, Margaret M Luthringer¹, Roman Povolotskiy¹, Ian C Hoppe², Mark S Granick¹

Affiliations

¹ Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
² Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson, MS, USA.

PMID: 35603017

Abstract

Background: Pediatric nasal bone fractures presenting as isolated fractures or with concomitant facial injuries are rare and not well documented. Analysis of treatment at an urban, level-one trauma center provides insight into their management.

Methods: Data were collected for pediatric nasal bone fractures diagnosed between January 2000 and December 2014. Patients were divided into groups based on presence or absence of isolated nasal bone fractures. Groups were compared using Chi-squared analysis, and a Bonferroni correction was used for a more conservative alpha (a = .004).

Results: Assault was the most common etiology presenting in 46 of 122 pediatric nasal bone fractures. There was no significant difference in surgical versus non-surgical management of isolated and non-isolated nasal bone fractures (P = 0.98). Treatment for both was predominantly watchful waiting in 91% to 95% of the cases followed by closed reduction in 3.2% to 3.3%. In the patients with isolated fractures, 11.5% sustained intracranial hemorrhage, compared to 35.6% of multifracture cases (P = .002); 15.0% of isolated fractures sustained a traumatic brain injury, compared to 55.9% of multifracture cases (P = .000003). No significant difference in fatality existed between groups (P = 0.53).

Conclusions: Multi-facial fracture cases were more likely to present with traumatic brain injuries and be admitted to the intensive care unit than isolated nasal bone fractures. Rates of surgical and non-surgical management were not significantly different between the 2 groups. Watchful waiting of pediatric nasal bone fractures was the management approach selected 92% to 95% of the time regardless of the presence or absence of concomitant facial fractures.

Keywords: Nasal bone fracture; facial fracture; facial trauma; pediatric facial fracture; pediatric nasal bone fracture.

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