Pediatric nasal bone fractures: does delayed treatment really lead to adverse outcomes?

OBJECTIVES

It is recommended that pediatric nasal bone fractures be treated earlier than in adults, within 3-7 days of the injury. This study was aimed at evaluating if delayed treatment could affect surgical outcomes of pediatric nasal bone fractures.

METHODS

Pediatric patients (≤17 years) with nasal bone fractures, who underwent corrective surgery between 2003 and 2011, were reviewed. Patients who underwent previous septo/rhinoplasty, or who had a previous nasal fractures and combined facial bone fracture, were excluded. A telephone survey was conducted, and clinical data and results from early (≤7 days) and delayed (>7 days) treatment groups were evaluated.

RESULTS

Out of 56 eligible patients, 48 (85.7%) underwent closed reduction (CR) only, and eight (14.3%) were given combined rhinoplastic (CR+) approaches. Out of 35 patients who underwent CR alone or CR+ and responded to the telephone interview, the long-term cosmetic results were good, with a median score of 2; the long-term nasal obstruction was minimal with a median score of 1. The median follow up period was 62 months (range 6-109). The elapsed time from injury to surgery did not affect patient satisfaction in terms of cosmetic outcomes (P=0.939) and nasal obstruction (P=0.264).

CONCLUSIONS

In pediatric nasal bone fractures, regardless of delayed or early treatment, the cosmetic outcome was consistently good, and nasal obstruction was nearly absent. Based on the time period from injury to surgery, the surgical outcome of delayed treatment group was also good.