Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Bone remodeling after conservative treatment of nasal bone fracture in pediatric patients

  • Kang, Won Ki (Department of Plastic and Reconstructive Surgery, Daegu Catholic University School of Medicine) ;
  • Han, Dong Gil (Department of Plastic and Reconstructive Surgery, Daegu Catholic University School of Medicine) ;
  • Kim, Sung-Eun (Department of Plastic and Reconstructive Surgery, Daegu Catholic University School of Medicine) ;
  • Lee, Yong Jig (Department of Plastic and Reconstructive Surgery, Daegu Catholic University School of Medicine) ;
  • Shim, Jeong Su (Department of Plastic and Reconstructive Surgery, Daegu Catholic University School of Medicine)
  • Received : 2020.05.15
  • Accepted : 2020.06.19
  • Published : 2020.06.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The standard treatment of nasal bone fractures in pediatric patients is closed reduction. Conservative treatment is sometimes performed, but poses a risk of nasal deformity. The aim of this study was to evaluate the outcomes of bone remodeling in pediatric nasal fractures. Methods: Information was extracted from the medical records of patients under 12 years of age who received conservative treatment for a nasal bone fracture and underwent follow-up computed tomography (CT) examinations. The initial fracture and its outcomes over time were graded as excellent, good, or fair according to the malalignment, displacement, or irregularity of the fractured segments. The outcomes of remodeling were evaluated through changes in the grade of the fracture between initial and subsequent CT scans. Results: The review identified 16 patients between March 2015 and December 2019. Their mean age was 6.2 years, and the average follow-up period was 4.9 months. Three of the five patients with a plane I frontal impact showed improved outcomes of remodeling from good to excellent, and the remaining two patients, improved from fair to good. Eight of the 11 patients with plane I lateral impacts showed improved outcomes, from good to excellent, while one patient, improved from fair to good, one patient, improved from fair to excellent, and one patient showed no interval changes. Conclusion: In 15 of these 16 patients with non-severe fractures, the bony contour improved through remodeling, without surgical intervention. Therefore, we suggest that conservative treatment is a feasible option for mild pediatric nasal fractures.

Keywords

References

  1. Higuera S, Lee EI, Cole P, Hollier LH Jr, Stal S. Nasal trauma and the deviated nose. Plast Reconstr Surg 2007;120(7 Suppl 2):64S-75S. https://doi.org/10.1097/01.prs.0000260722.91183.50
  2. Desrosiers AE 3rd, Thaller SR. Pediatric nasal fractures: evaluation and management. J Craniofac Surg 2011;22:1327-9. https://doi.org/10.1097/SCS.0b013e31821c932d
  3. Oh M, Kim YS, Youn HH, Choe J. Clinical analysis of pediatric facial bone fracture; 10-years experiences in 201 cases. J Korean Soc Plast Reconstr Surg 2005;32:55-9.
  4. Hong SB, Choi BW, Suh IS, Ha JH. Clinical & radiologic evaluation of the nasal bone fractures. J Korean Soc Plast Reconstr Surg 1996;23:1572-82.
  5. Lee JH, Park WY, Nam HJ, Kim YH. Complications of the nasal bone fractures according to the Stranc classification. J Korean Cleft Palate-Craniofac Assoc 2008;9:62-6.
  6. Rohrich RJ, Adams WP Jr. Nasal fracture management: minimizing secondary nasal deformities. Plast Reconstr Surg 2000;106:266-73. https://doi.org/10.1097/00006534-200008000-00003
  7. Lee KS, Park JB, Song SH, Oh SH, Kang NH. Delayed reduction of facial bone fractures. Arch Craniofac Surg 2013;14:119-23. https://doi.org/10.7181/acfs.2013.14.2.119
  8. Stranc MF, Robertson GA. A classification of injuries of the nasal skeleton. Ann Plast Surg 1979;2:468-74. https://doi.org/10.1097/00000637-197906000-00004
  9. Lee BM, Han DG. Acute bone remodeling after reduction of nasal bone fracture on computed tomography imaging. Arch Craniofac Surg 2014;15:63-9. https://doi.org/10.7181/acfs.2014.15.2.63
  10. Chong HK, Choi JW, Chun JH, Kim IJ, Kang YJ. The usefulness of nasal bone CT in diagnosis of the nasal bones fractures of children. J Korean Soc Plast Reconstr Surg 1999;26:74-8.
  11. Kang SJ, Kim SK. The utility of thin section CT in pediatric nasal bone fracture. J Korean Cleft Palate-Craniofac Assoc 2003;4:104-6.
  12. Motomura H, Muraoka M, Tetsuji MY, Ozawa MT, Nose MK. Changes in fresh nasal bone fractures with time on computed tomographic scans. Ann Plast Surg 2001;47:620-4. https://doi.org/10.1097/00000637-200112000-00007
  13. Tremolet de Villers Y. Nasal fractures. J Trauma 1975;15:319-27. https://doi.org/10.1097/00005373-197504000-00008
  14. Dahlin C, Linde A, Gottlow J, Nyman S. Healing of bone defects by guided tissue regeneration. Plast Reconstr Surg 1988;81:672-6. https://doi.org/10.1097/00006534-198805000-00004

Cited by

  1. Comparison of postoperative outcomes between early and delayed surgery for pediatric nasal fractures vol.22, pp.2, 2020, https://doi.org/10.7181/acfs.2021.00122