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Case 5 - Cominuted Nasal Bone Fracture

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I'd like to relook at this child who fell out of the stroller and

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look at the facial bones from the standpoint of

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nasal bone fractures. So as we scroll upward,

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we're going to ignore the patient's orbital fractures

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and now focus on the nasal bones.

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And what you can see is a comminuted fracture of the right

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nasal bone which is indented inward and

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displaced from its normal appearance.

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Here we can see some of the sutures that are associated

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with the nasal bones, and they actually are not involved.

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This is angulated,

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but the fracture is actually more distal to that.

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If we look at the superior, most aspect of the nasal bones,

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we see that there is a fracture which is going through the

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superior anterior portion of the nasal bones and then down

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to this line here. Looking at that on the coronal image,

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what you see is a fracture line which is

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just to the right of the crista galli.

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And this is going downward in orientation just to the right

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of midline and entering into the frontonasal suture.

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So this is an example of a fracture that is going into the

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frontal bone and projecting downward to the frontonasal

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suture as well as involvement of the right nasal bone

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at the frontomaxillary suture seen on the right side.

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Notice that if we look at the nasal septum again,

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something important to look at repeatedly is to look for

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the integrity of this septum and that looks just fine.

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So, an example of right-side nasal fracture

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as well as frontonasal suture fracture.

Report

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Neuroradiology

Head and Neck

Emergency

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