Case 5 - Cominuted Nasal Bone Fracture
HIDEInteractive Transcript
0:01
I'd like to relook at this child who fell out of the stroller and
0:06
look at the facial bones from the standpoint of
0:11
nasal bone fractures. So as we scroll upward,
0:15
we're going to ignore the patient's orbital fractures
0:17
and now focus on the nasal bones.
0:19
And what you can see is a comminuted fracture of the right
0:24
nasal bone which is indented inward and
0:27
displaced from its normal appearance.
0:30
Here we can see some of the sutures that are associated
0:34
with the nasal bones, and they actually are not involved.
0:36
This is angulated,
0:38
but the fracture is actually more distal to that.
0:42
If we look at the superior, most aspect of the nasal bones,
0:47
we see that there is a fracture which is going through the
0:52
superior anterior portion of the nasal bones and then down
0:56
to this line here. Looking at that on the coronal image,
1:01
what you see is a fracture line which is
1:03
just to the right of the crista galli.
1:07
And this is going downward in orientation just to the right
1:11
of midline and entering into the frontonasal suture.
1:15
So this is an example of a fracture that is going into the
1:20
frontal bone and projecting downward to the frontonasal
1:25
suture as well as involvement of the right nasal bone
1:30
at the frontomaxillary suture seen on the right side.
1:37
Notice that if we look at the nasal septum again,
1:40
something important to look at repeatedly is to look for
1:44
the integrity of this septum and that looks just fine.
1:48
So, an example of right-side nasal fracture
1:51
as well as frontonasal suture fracture.
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
© 2024 MRI Online. All Rights Reserved.