A nasal fracture, commonly known as a broken nose, is a break or crack in the bone or cartilage forming the nasal structure. This injury is the most common type of facial fracture. Trauma can range from a hairline crack to severe displacement of the nasal bones and the internal septum. Many people delay treatment, mistakenly believing the injury will heal without intervention. Allowing a displaced fracture to heal naturally, however, leads to serious, long-term consequences affecting both function and appearance.
Permanent Impairment of Breathing
The most significant functional outcome of an untreated nasal fracture is the permanent impairment of nasal breathing. A forceful blow can fracture the nasal septum, the thin wall of bone and cartilage separating the two nasal passages, causing it to shift out of alignment. If this deviation is not corrected, it heals in a crooked position, leading to chronic nasal obstruction in one or both nostrils, which restricts airflow and forces reliance on mouth breathing. Reduced airflow impacts quality of life, causing decreased endurance during physical activity and constant congestion. Chronic nasal obstruction also contributes to sleep disturbances, including loud snoring and worsening obstructive sleep apnea. Correcting this permanent problem later requires a septoplasty, a surgical procedure focused on straightening the internal septum.
Lasting Structural Deformity
When nasal bones and cartilage heal without being properly reset, they fuse in their displaced position, resulting in a lasting change to the nose’s external appearance. The nose may become visibly crooked or shifted away from the facial midline. Trauma can also cause the nasal bones to collapse or widen, leading to a flattening of the bridge or an unnaturally broad appearance. Another common outcome is the formation of a dorsal hump, which results from misplaced bony fragments or new bone growth healing over the fracture site. Correcting these external changes requires complex reconstructive surgery, known as post-traumatic rhinoplasty or septorhinoplasty, once the bones have stabilized after several months.
Risk of Septal Hematoma and Abscess
One dangerous acute complication of nasal trauma is the formation of a septal hematoma, which is a collection of blood pooling beneath the lining of the nasal septum. This condition is a medical emergency demanding immediate attention. The accumulated blood separates the cartilage from its overlying membrane, which is the sole source of nutrients for the cartilage tissue. If the hematoma is not promptly incised and drained, the cartilage will suffer necrosis, or tissue death, resulting in the loss of structural support for the nasal bridge. This collapse leads to a severe deformity known as a “saddle nose,” characterized by a scoop-like dip in the nasal profile. Furthermore, an untreated hematoma risks becoming infected, forming an abscess that could potentially spread the infection to surrounding facial structures or even the brain.
The Urgent Window for Treatment
The time elapsed between the injury and treatment is the most important factor determining the complexity of the repair. A simple, non-surgical procedure called closed reduction is possible only while the fractured bones remain mobile. This window is typically limited to the first seven to fourteen days following the injury, before the bones begin to permanently fuse in the wrong position. If treatment is delayed beyond this narrow window, the fracture site will consolidate, or harden, making simple manipulation impossible. Patients who miss this opportunity must wait a minimum of three to six months for the bone and scar tissue to fully stabilize. The eventual correction then requires an open surgical approach involving osteotomies, which are precise surgical cuts to re-fracture the bones, followed by complex reconstruction techniques. Seeking immediate medical evaluation is necessary to confirm the diagnosis and determine the appropriate and simplest path to functional and structural recovery.