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No evidence for early manipulation of nasal fractures

Three Part Question

In [adults with displaced nasal fracture without gross swelling] is [early reduction better than late reduction] at [optimising functional and cosmetic recovery]?

Clinical Scenario

A 27 year old man attends the Emergency Department having been involved in a fight. He had been hit on the nose and has an obvious displaced nasal fracture without septal haematoma. As yet there is no gross swelling. You wonder whether immediate reduction would be better than delayed reduction.

Search Strategy

Medline 1966-03/00 using the OVID interface.
({exp nose OR exp nose deformities, acquired OR} AND {exp fractures OR}) AND maximally sensitive RCT filter LIMIT to human AND english.

Search Outcome

104 papers found of which none were relevant.


There is no direct evidence that can assist in answering this question.

Clinical Bottom Line

Local advice should be followed.