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December 1984

Open ν Closed Reduction of the Fractured Nose

Author Affiliations

From the Department of Otolaryngology, Royal Infirmary of Edinburgh (Drs Murray, Maran, and Mackenzie), and the Department of Statistics, University of Edinburgh (Mr Raab).

Arch Otolaryngol. 1984;110(12):797-802. doi:10.1001/archotol.1984.00800380027008

• A stepwise study of nasal fractures includes an initial investigation that was carried out to discover why so many patients were awaiting rhinoplasty, which led us to find a 30% to 40% failure rate in nasal manipulation operations. We then studied the mechanics of nasal fracture by striking fresh cadaver noses. We found that if the nasal bones were deviated by more than half the bridge width, there was a concomitant C-shape fracture of the bony and cartilaginous septum. Two trials were performed, and patients with nasal deviation after trauma were allocated to either manipulation or manipulation plus excision of septal cartilage (closed or open reduction). Both trials were statistically significant, indicating that open reduction is the preferred treatment for patients with a deviation of more than half the bridge width of the nose.

(Arch Otolaryngol 1984;110:797-802)

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