Arch Craniofac Surg.  2019 Mar;20(1):24-30. 10.7181/acfs.2018.02222.

Finger reduction of nasal bone fracture under local anesthesia: outcomes and patient reported satisfaction

• Lee YJ
• Lee KT
• Pyon JK

• KMID: 2441935
• DOI: http://doi.org/10.7181/acfs.2018.02222

Abstract

BACKGROUND
Closed reduction of the fracture under general or local anesthesia with elevators or forceps is widely used to treat nasal bone fractures. However, operating under general anesthesia increases the risk of morbidity and raises the cost of management. Furthermore, using forceps or elevators may cause undercorrection, new fractures, mucosal damage, and nasal hemorrhage. We therefore performed manual reduction under local anesthesia, using the little finger, to minimize the demerits of treatment under general anesthesia with forceps or elevators and aimed to assess functional and aesthetic outcomes, and patient satisfaction.
METHODS
Patients who visited the plastic and reconstructive surgery department between November 2016 and November 2017 with nasal bone fractures and treated by a single surgeon were prospectively followed up. Patients with simple unilateral or bilateral nasal bone fractures were treated with bedside finger reduction under local anesthesia and patients with comminuted nasal bone or septal fractures were scheduled for closed reduction under general anesthesia.
RESULTS
Of 84 patients, 28 met the inclusion criterion and underwent bedside finger reduction under local anesthesia. Twenty-seven patients (96.4%) were successfully contacted via telephone for survey. Twenty-three (85.2%) showed good and three (11.1%) showed fair results. All 27 patients (100%) were satisfied with their postoperative function and 25 (92.6%) were satisfied with their postoperative aesthetic result. Twenty-five patients (92.6%) preferred the finger reduction method under local anesthesia over closed reduction under general anesthesia.
CONCLUSION
Finger reduction under local anesthesia in patients with mild unilateral or bilateral nasal bone fractures is an easy and efficient procedure with high patient satisfaction and favorable postoperative functional and aesthetic outcomes.

Keyword

Acquired nose deformity; Bone fracture; Finger; Fracture; Local anesthesia; Nasal bone; Nose; Patient satisfaction; Reduction; Rhinoplasty

MeSH Terms

Anesthesia, General
Anesthesia, Local*
Elevators and Escalators
Fingers*
Fractures, Bone
Hemorrhage
Humans
Methods
Nasal Bone*
Nose
Nose Deformities, Acquired
Patient Satisfaction
Plastics
Prospective Studies
Rhinoplasty
Surgical Instruments
Telephone
Plastics