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Patients Dissatisfied Following Closed Reduction Of Nasal Fractures

A report in the January/February issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals, finds that nearly one-third of the patients who underwent closed reduction of nasal fractures //reported dissatisfaction with the outcome and said they would consider further surgery to correct their nasal deformities.

Closed reduction, the standard procedure to repair a broken nose, involves repositioning nasal bones without an open surgical incision. It is typically performed within seven days of nasal fracture for children and within 10 days for adults.

'This method, although simple, fails to address deformities of the cartilaginous framework and the nasal septum caused by the injury,' the authors write. 'Increasing evidence shows that patients have persistent aesthetic concerns about the outcome and obstructive symptoms after closed reductions.'

Terry Hung, M.B.Chir, F.R.C.S., and colleagues at The Chinese University of Hong Kong, Prince of Wales Hospital, interviewed 62 patients who underwent a closed reduction between July 1, 2002, and June 30, 2005. The interviews assessed patients' satisfaction and the severity of their deformity aesthetically and functionally both before and after the procedure. Satisfaction and severity were assessed on a scale from one to five, with one being very satisfied or least severe and five being very dissatisfied and most severe.

Fifty patients (81 percent) were male and 12 (19 percent) were female, and they had an average age of 27.7 years. Forty-five percent of nasal fractures were caused by sports injuries, 23 percent by physical altercations or assaults and 10 percent by motor vehicle crashes. The average score for nasal deformity was 3.08 before surgery and 1.62 after surgery, the average score for aesthetic concern was 2.97 before surgery and 1.54 following, and the average score for nasal obstruction was 2.03 before surgery and 1.36 after surgery. Following the cl
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