Nasal fracture repositioning procedures include closed repositioning, open repositioning and endonasal endoscopic repositioning. The steps are generally divided into preoperative swelling, anesthesia, corrective repositioning, filling and fixation.
1. Preoperative swelling reduction: Nasal bone fracture reduction surgery needs to be carried out after the swelling of nasal soft tissue is eliminated.
2. Anesthesia: local anesthesia or general anesthesia can be chosen according to the specific conditions of the patient, and general anesthesia is more often used for children or severe swelling of the mucous membrane in the nasal cavity.
3. Corrective repositioning: choose the appropriate nasal bone repositioning forceps, the right hand holds the instrument into the nasal cavity fracture site, push upward and outward to lift the fracture fragments, the left hand presses on the bridge of the nose and pushes on the healthy side of the nasal bone, and when the bone rubbing sound is heard, the bone will be repositioned. After reset, check the X-ray film to confirm whether the reset is good.
4. Filling and fixation: After surgical repositioning, the nasal cavity is filled with petroleum jelly gauze to achieve the purpose of fixation, support and hemostasis. The filler is usually removed after 24 hours and the nose is protected from pressure for 2 weeks after surgery.
Each patient’s situation is somewhat different, and the surgeon will choose the best surgical plan according to the specific situation.