scholarly journals Antibiotic use in nasal bone fracture: a single-center retrospective study

2021 ◽  
Vol 22 (6) ◽  
pp. 319-323
Author(s):  
Ji Hyuk Jung ◽  
Yeo Reum Jeon ◽  
Joon Ho Song ◽  
Seum Chung
Keyword(s):  
Retrospective Study ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Antibiotic Use ◽  
Careful Consideration ◽  
Antibiotic Usage ◽  
Nasal Packing ◽  
Related Complication

Background: Prophylactic antibiotics are used to prevent surgical wound infection; however, proper indications must be followed with careful consideration of the risks and benefits, especially in clean or clean-contaminated wounds. Nasal bone fractures are the most common type of facial bone fracture. The most common method for treating nasal bone fracture is closed reduction, which is performed inside the nasal cavity without an incision. The purpose of this study was to determine the need for antibiotic use in the closed reduction of nasal bone fractures.Methods: A retrospective study was conducted using data from the National Insurance Service Ilsan Hospital of the Republic of Korea between 2016 and 2018. The records of patients who underwent closed reduction of nasal bone fracture were reviewed and classified according to sex, age, comorbidities, perioperative antibiotic usage, postoperative complications, nasal packing, anesthesia type, surgeon’s specialty, and operation time.Results: Among the 373 patients studied, the antibiotic prescription rate was 67.3%. Just 0.8% of patients were prescribed preoperative antibiotics only, 44.0% were prescribed postoperative antibiotics only, and 22.5% were prescribed both preoperative and postoperative antibiotics. There were no cases that satisfied the definition of “surgical site infection.” Furthermore, 2.1% of infection-related complications (e.g., mucosal swelling, synechia, and anosmia) occurred only in the antibiotic usage group. The use of nasal packing, anesthesia type, and surgeon’s specialty did not show any difference in infection-related complication rates.Conclusion: According to the study findings, the routine use of perioperative antibiotics is not recommended in uncomplicated nasal bone fracture surgery.

scholarly journals Effectiveness of Closed Reduction in the treatment of nasal bone fractures

2021 ◽  
Vol 23 (1) ◽  
pp. 37-40
Author(s):  
Brihaspati Sigdel ◽  
K Sah
Keyword(s):  
Bone Fracture ◽  
Closed Reduction ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Bone Fractures ◽  
Nasal Bone ◽  
College Teaching ◽  
Road Traffic Accidents ◽  
Functional Abnormality ◽  
Nasal Injury

This study was conducted to investigate the effectiveness of closed reduction of nasal bone fracture according to severity. It was a retrospective study carried on 60 patients with mean age of 30.2 years (range 10-67 years) who have undergone a closed reduction of a nasal bone fracture at Gandaki Medical College Teaching Hospital from January 2017 to December 2019. The patient with nasal bone fracture who underwent surgical intervention with closed reduction under General anaesthesia were included in this study. Fracture severity was evaluated according to Hwang et al.’s classification method. All patients underwent closed reduction with external nasal splinting under General anesthesia. The patients were followed-up for at least three months to assess the complications, such as fracture recurrence and functional abnormality in the Department. The most common cause of nasal bone fracture was road traffic accidents 25 (41.6%) followed by physical assaults 18 (30%), fall injuries 12 (20%), other incidences 3 (5%), and industrial accidents 2 (3%). Forty-three (72%) cases underwent closed reduction within 24 hours of those who arrived within 4-6 hour of nasal injury in the hospital and the remaining 17 (28%) cases were reduced after 5 days of trauma. Concurrent fracture found in 8 (13%) cases and it included maxillary, zygomatic, orbital, frontal bone fracture. Nasal bone fracture mostly occurs in road traffic accidents. Closed reduction with good alignment is the preferred method. Septorhinoplasty and extracorporeal septoplasty should be applied in difficult and comminuted nasoseptal fracture.

scholarly journals The Retrospective Study of Closed Reduction of Nasal Bone Fracture

2014 ◽  
Vol 36 (6) ◽  
pp. 266-272 ◽  
Author(s):  
Han-Kyul Park ◽  
Jae-Yeol Lee ◽  
Jae-Min Song ◽  
Tae-Seup Kim ◽  
Sang-Hun Shin
Keyword(s):  
Retrospective Study ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Nasal Bone

scholarly journals Antibiotic use in nasal bone fracture: a nationwide population-based cohort study in Korea

2021 ◽  
Vol 22 (5) ◽  
pp. 254-259
Author(s):  
Yeo Reum Jeon ◽  
Ji Hyuk Jung ◽  
Joon Ho Song ◽  
Seum Chung
Keyword(s):  
Cohort Study ◽  
General Anesthesia ◽  
Closed Reduction ◽  
Bone Fractures ◽  
Antibiotic Prescription ◽  
Inappropriate Prescribing ◽  
Nasal Bone ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Prescribing Patterns

Background: Prophylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea.Methods: This retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis.Results: A total of 3,678 patients (mean± standard deviation of age, 28.7± 14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed.Conclusion: The findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.

scholarly journals A retrospective clinical investigation for the effectiveness of closed reduction on nasal bone fracture

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Byung-Hun Kang ◽  
Hyo-Sun Kang ◽  
Jeong Joon Han ◽  
Seunggon Jung ◽  
Hong-Ju Park ◽  
...  
Keyword(s):  
Bone Fracture ◽  
Closed Reduction ◽  
Traffic Accident ◽  
Bone Fractures ◽  
Clinical Investigation ◽  
Nasal Bone ◽  
Surgical Techniques ◽  
High Rate ◽  
Radiographic Images ◽  
Current Trends

Abstract Background The nasal bone is the most protruding bony structure of the facial bones. Nasal bone fracture is the most common facial bone fracture. The high rate of incidence of nasal bone fracture emphasizes the need for systematical investigation of epidemiology, surgical techniques, and complications after surgery. The objective of this study is to investigate the current trends in the treatment of nasal bone fractures and the effectiveness of closed reduction depending on the severity of the nasal bone fracture. Patients and methods A total of 179 patients with a nasal bone fracture from 2009 to 2017 were enrolled. Their clinical examination, patient’s records, and radiographic images of nasal bone fractures were evaluated. Results Patients ranged from children to elderly. There were 156 (87.2%) males and 23 (12.8%) females. Traffic accident (36.9%) was the most common cause of nasal fracture. Orbit fracture (44 patients, 24.6%) was the most common fracture associated with a nasal bone fracture. Complications after surgery included postoperative deformity in 20 (11.2%) patients, nasal obstruction in 11 (6.1%) patients, and olfactory disturbances in 2 (1.1%) patients and patients with more severe nasal bone fractures had higher rates of these complications. Conclusion Closed reduction could be performed successfully within 2 weeks after injury.

scholarly journals Satisfaction level in patients with nasal bone fracture following closed reduction: a follow-up single-centre study from New Delhi, India

2021 ◽  
Vol 8 (7) ◽  
pp. 2123
Author(s):  
Raghavendra Kaladagi ◽  
Madhusoodan Gupta ◽  
Manoj K. Johar ◽  
Abid Saleem ◽  
Pradeep K. Singh ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Bone Fractures ◽  
Nasal Bone ◽  
New Delhi ◽  
Single Centre Study ◽  
The Face ◽  
Previously Treated Patients ◽  
The Aesthetic

Background: Nose, because of its prominence and central location in the face is more prone to injury. Nasal bone fractures (NBFs) are one of the most common fractures in patients with maxillofacial injuries. The closed reduction of NBFs is well documented and results in varied clinical outcomes. There is paucity over detailed reports on patient satisfaction in terms of functional and aesthetic aspects as well as the reasons for dissatisfaction of the same.Methods: We had conducted a prospective cohort study of previously treated patients to evaluate the postoperative functional and aesthetic outcomes like patient satisfaction following closed reduction of NBFs in the department of plastic surgery.Results: The average age of patients was 40.61 years (SD±15.83), of which 63.7% were male and 36.21% female. The major cause of fracture was found to be RTA (55.17%). The satisfaction as happy (9-10 score) reported by 60.34% patients for functional aspect and 41.38% patients for the aesthetic aspect of closed reduction of NBFs.Conclusions: Our study demonstrated comparatively good satisfaction results in terms of functional and aesthetic aspects following closed reduction. Closed reduction technique of nasal bone fracture is simple, safe, and easy to perform with minimal potential morbidity.

scholarly journals Precisely Closed Reduction of Nasal Bone Fracture Assisted With Plain Film Measurements Under the Picture Archiving and Communication System

2021 ◽  
pp. 014556132110121
Author(s):  
Tzu-Hsien Yang ◽  
Chien-Liang Fang ◽  
Chong-Bin Tsai ◽  
Ming-Shan Chen ◽  
Chih-Hsuan Changchien ◽  
...  
Keyword(s):  
Bone Fracture ◽  
Communication System ◽  
Closed Reduction ◽  
Operative Time ◽  
Nasal Bone ◽  
Plain Film ◽  
Ao Classification ◽  
Group A ◽  
Picture Archiving And Communication ◽  
Group B

Objectives: To prevent aesthetic and functional deformities, precisely closed reduction is crucial in the management of nasal fractures. Plain film radiography (PF), ultrasonography (USG), and computed tomography can help confirm the diagnosis and classification of fractures and assist in performing closed reduction. However, no study in the literature reports on precisely closed reduction assisted with PF measurements under the picture archiving and communication system (PACS). Methods: We retrospectively evaluated 153 patients with nasal bone fracture between January 2013 and December 2017. Surgeons conducted precisely closed reduction assisted with PF measurement of the distance between the fracture site and nasal tip under PACS on 34 patients (group A). Another group on 119 patients were reduced under surgeon’s experience (group B). Results: No significant differences in age, gender, Arbeitsgemeinschaft fur Osteosynthesefragen (AO) classification, and reduction outcome were observed between group A and group B ( P > .05). The operative time of the group A was significantly lower (12.50 ± 4.64 minutes) compared to group B (23.78 ± 11.20 minutes; P < .001). After adjusted age, gender, and AO classification, patients in group A scored 10.46 minutes less on the operative time than those in group B ( P < .001). In addition, the severity of nasal bone fracture (AO classification, β = 3.37, P = .002) was positive associated with the operative time. Conclusions: In this study, closed reduction in nasal bone fracture assisted with PF measurements under PACS was performed precisely, thereby effectively decreasing operative time and the occurrence of complications. This procedure requires neither the use of new instruments or C-arm nor USG or navigation experience. Moreover, reduction can be easily performed using this method, and it requires short operative time, helps achieve great reduction, less radiation exposures, and is cost-effective.

scholarly journals External Fixation of Unstable, “Flail” Nasal Fractures

2012 ◽  
Vol 5 (2) ◽  
pp. 99-105 ◽  
Author(s):  
George E. Anastassov ◽  
Ali Payami ◽  
Zain Manji
Keyword(s):  
External Fixation ◽  
Closed Reduction ◽  
Nasal Septum ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Facial Fractures ◽  
Kirschner Wires ◽  
Nasal Bones ◽  
External Stabilization ◽  
Nasal Fractures

Nasal bone fractures are the most common among facial fractures. Usually these are adequately treated with closed reduction and internal and/or external stabilization with splints. However, there are clinical situations where the nasal bones are severely displaced, the nasal septum fractured and displaced, or there are external drape lacerations which preclude the use of nasal splints. If the nasal bones are reducible but unstable we consider them “flail” and in this case transmucosal, endonasal Kirschner wires are used for dorsal support until sufficient healing occurs. The technique is simple, quick, and predictable and causes minimal discomfort to the patients.

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