Outcomes following manipulation of nasal fractures-the Durham experience.

Background: Early manipulation of nasal fractures can negate the need for formal rhinoplasty. However, residual nasal deformity is reported in up to 50 % of cases. The aim of this study was to evaluate the outcome following manipulation of nasal fractures in a regional plastic surgery department and quantify the subsequent rhinoplasty conversion rate. Methods: A retrospective review of all patients presenting with nasal fractures who had undergone manipulation under anaesthetic (MUA) in a single plastic surgery unit over a 7-year period was performed. Results: Three hundred fifty-three MUA procedures were performed, the majority of which were in young males (76 %). Common causes included assault (54 %), sporting injuries (24 %) and falls (12 %). MUA was performed for nasal bone fracture (69 %) or bony and septal fracture (31 %). Only 37 % (130 patients) attended outpatient follow-up. Functional problems were identified in 17 % (22 patients), whilst 24 % (31 patients) noted residual deformity. Of these, 10 patients (3 %) accepted and underwent formal rhinoplasty surgery. This accounted for 17 % of all rhinoplasties carried out within the time period. Conclusions: In our department, the outcome following manipulation of these injuries compares favourably with the literature, with the majority of patients having no major long-term sequelae. Our data suggest that many patients are happy to accept a degree of residual deformity and decline further surgery. Level of Evidence: Level IV, risk / prognostic study [ABSTRACT FROM AUTHOR]