Manoj Gupta¹*, Dhaval Bhojani² and Sudhakar Vaidya³

¹Resident, Department of ENT, R.D Gardi Medical College, Ujjain, M.P., India
²Senior Resident, Department of ENT, R.D Gardi Medical College, Ujjain, M.P., India
³Professor and Head, Department of ENT, R.D Gardi Medical College, Ujjain, M.P., India

*Corresponding Author: Manoj Gupta, Resident, Department of ENT, R.D Gardi Medical College, Ujjain, M.P., India.

Received: May 01, 2024; Published: June 17, 2024

Abstract

Introduction: The most common type of facial bone fracture involves the nasal bones. They are often linked to physical assault, falls, sports injuries, and traffic accident. Traditionally, these fractures are treated through closed reduction under either general or local anesthesia using forceps or elevators. However, the use of general anesthesia poses risks and increases costs, while forceps or elevators may lead to various complications such as under-correction, new fractures, mucosal damage, and nasal bleeding.

To mitigate these issues, we conducted manual reduction under local anesthesia, employing the little finger. Our objective was to minimize the drawbacks associated with general anesthesia and instrument-based reduction methods. Our study aimed to evaluate both functional and aesthetic outcomes, as well as patient satisfaction with this approach.

Methods: During the period from October 2022 to October 2023, individuals (male and female of 15-65 years age group fit for surgery)who sought treatment at the E.N.T. Department for nasal bone fractures and were attended to by a singular surgeon were subject to prospective monitoring. We report our attempt to reduce unilateral or bilateral nasal bone fractures who underwent finger reduction, administered under local anesthesia and the favorable postoperative clinical course.

Results: A study was conducted on 50 patients with nasal bone fractures, who underwent bedside finger reduction under local anesthesia. All patients achieved favorable reductions, as determined by external appearance and x-ray nasal bone lateral view or CT nasal bone. The patients were aged 10-65 years, with an average follow-up period of 3 months. All patients were satisfied with their functional and aesthetic outcomes, with 90% showing good results and 10% experiencing some edema post-operatively over the nose and around which subsided in one week.

Conclusion: Under local anesthesia, finger reduction for mild unilateral or bilateral nasal bone fractures proves to be a straightforward and effective procedure, yielding high patient satisfaction and positive postoperative functional and aesthetic results.

 Keywords: Finger Reduction; Nasal Bone Fracture; Local Anesthesia; Outcomes; Case Series; Closed Reduction

References

1. Takahashi K., et al. “An analysis of 227 nasal bone fractures”. Journal of Plastic and Reconstructive Surgery 22 (2002): 271Y276.
2. Bowerman E. “Fractures of the middle third of the facial skeleton”. In: Rowe N-L, Williams J-LL, eds. Maxillofacial Injuries. Vol. 1. New York: Churchill Livingstone Inc, (1985): 363Y433.
3. Kurihara K., et al. “Clinical study of new nasal bone fractures”. Journal of Plastic and Reconstructive Surgery 33 (1990): 113Y120.
4. Aloin H. “A propose du treatment des fractures du nez. note de tequnique chirurgicale”. Journal français d'oto-rhino-laryngologie 1 (1952): 302.
5. Humber P-R and Horton C-E. “Trauma to the nose”. In: Stark R-B, ed. Plastic Surgery of the Head and Neck. New York: Churchill Livingstone Inc, (1987): 390Y401
6. Schultz R-C and deVillers Y-T. “Nasal fractures”. Journal of Trauma 15 (1975): 319.
7. Tabassom A and Dahlstrom JJ. StatPearls. StatPearls Publishing; Treasure Island (FL): Sep 12, (2022).
8. Higuera S., et al. “Nasal trauma and the deviated nose”. Plastic and Reconstructive Surgery 120 (2007): 64S-75S.
9. Swenson DM., et al. “Epidemiology of US high school sports-related fractures, 2005-2009”. Clinical Journal of Sport Medicine 4 (2010): 293-299.
10. Kim KS., et al. “Trend analysis of nasal bone fracture”. Archives of Craniofacial Surgery4 (2018): 270-274.
11. Rubinstein B and Strong EB. “Management of nasal fractures”. Archives of Family Medicine 9 (2000): 738–742.
12. Love RL. “Nasal fractures: patient satisfaction following closed reduction”. The New Zealand Medical Journal 123 (2010): 45-48.
13. Ichida M., et al. “A repositioning technique for nasal fracture using the little finger”. Journal of Craniofacial Surgery 19 (2008): 1512-1517.
14. Tajima S. “Treatment of Facial Bone Fractures”. 2nd ed. Tokyo, Japan: Kokuseido Publishing, (1999): 143Y174.
15. Paul N. “Manson: facial fractures”. In: Sherrell J-A, Robert W, Beasley C, et al, eds. Plastic Surgery. 5^th Philadelphia, PA: Lippincott-Raven Publishers, (1997): 383Y411.
16. Young-Jae Lee., et al. “Finger reduction of nasal bone fracture under local anesthesia: outcomes and patient reported satisfaction”. Journal of Craniofacial Surgery1 (2019): 24-30.
17. Nithya Balasubramanian and Rajasekar M K. “Closed Reduction of Nasal Bone Fracture-a Case Series”. Journal of Research in Medical and Dental Science 5 (2022): 7-9.

Citation

Citation: Manoj Gupta., et al. “Finger Reduction of Nasal Bone Fracture Under Local Anesthesia and its Outcomes - A Case Series".Acta Scientific Otolaryngology 6.7 (2024): 02-09.

Copyright

Copyright: © 2024 Manoj Gupta., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.