No evidence for early manipulation of nasal fractures

Date First Published:

March 1, 2000

Last Updated:

April 11, 2001

Report by:

Terry Gilpin, Specialist Registrar (Manchester Royal Infirmary)

Search checked by:

Simon Carley, Manchester Royal Infirmary

Three-Part Question:

In [adults with displaced nasal fracture without gross swelling] is [early reduction better than late reduction] at [optimising functional and cosmetic recovery]?

Clinical Scenario:

A 27 year old man attends the Emergency Department having been involved in a fight. He had been hit on the nose and has an obvious displaced nasal fracture without septal haematoma. As yet there is no gross swelling. You wonder whether immediate reduction would be better than delayed reduction.

Search Strategy:

Medline 1966-03/00 using the OVID interface.

Search Details:

({exp nose OR exp nose deformities, acquired OR nose.mp} AND {exp fractures OR fracture.mp}) AND maximally sensitive RCT filter LIMIT to human AND english.

Outcome:

104 papers found of which none were relevant.

Author Commentary:

There is no direct evidence that can assist in answering this question.

Bottom Line:

Local advice should be followed.