Nasal fractures are very common. After the initial injury, there is usually a significant amount of swelling and some nasal bleeding. At the initial evaluation, any other potentially severe injuries should be evaluated and ruled out before treatment of most facial fractures. A septal hematoma (collection of blood in the area that divides the two sides of the nose) should be ruled out at the time of initial injury to avoid infection and collapse of the nose.
After the initial swelling calms down, any deviation or deformity of the nose can be detected. A large deformity of the nose can be corrected initially with a closed reduction in the office or operating room. Fine corrections of nasal and septal deformities usually require a rhinoplasty after a few months. This allows time for the body to heal and all swelling to resolve before any decisions on changing the appearance of the nose are made.
Other facial fractures usually require a fine cut CT scan for evaluation of all bony injuries. After all other life-threatening injuries are attended to, facial fractures are usually addressed after some of the swelling has resolved unless there is direct involvement from the fracture to a critical area such as the globe of the eye. Sometimes temporizing measures are done until the patient is stable enough for fine fracture repair.