21310 Closed treatment of nasal bone fracture without manipulation

Name of the Procedure:

Closed treatment of nasal bone fracture without manipulation (also known as Closed Nasal Reduction or Conservative Management of Nasal Fracture)

Summary

This procedure involves treating a broken nose (nasal bone fracture) without manually realigning the bones. It focuses on allowing the fracture to heal naturally without surgical intervention or physical manipulation.

Purpose

This procedure addresses nasal bone fractures where the bones remain relatively well-aligned despite the break. The goal is to stabilize the fracture, alleviate pain, and ensure proper healing without causing additional trauma through manipulation.

Indications

• Mild to moderate nasal bone fractures with minimal displacement
• Patients who experience significant pain, swelling, or nasal obstruction as a result of the fracture
• Individuals without severe deformities or functional impairments due to the fracture

Preparation

• Generally, no special preparation is needed.
• Patients may be advised to avoid certain medications that could increase bleeding risk, such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).
• An initial evaluation including a physical examination and possibly imaging studies (e.g., X-rays) to assess the extent of the fracture.

Procedure Description

1. The patient is seated or lying down in a comfortable position.
2. Pain management may include the use of local anesthesia or oral pain relievers.
3. The nose is supported with a splint or padding to minimize movement and promote proper alignment during the healing process.
4. The patient receives instructions on how to care for the nose during the healing period.

Duration

The procedure itself is quick, generally taking less than 30 minutes. However, initial consultation and assessment may extend the total time spent in the medical facility.

Setting

The procedure is commonly performed in a physician’s office, outpatient clinic, or emergency room.

Personnel

• The procedure is typically carried out by an ENT (ear, nose, and throat) specialist or a skilled general practitioner.
• A nurse or medical assistant may be present to assist with preparation and patient care.

Risks and Complications

• Minor bleeding or bruising
• Nasal congestion or obstruction
• Rarely, improper healing of the fracture or nasal deformity, which may require further intervention

Benefits

• Reduced risk of additional trauma compared to more invasive procedures.
• Natural healing without the need for surgical intervention.
• Pain relief and stabilization of the fracture.

Recovery

• Patients should avoid strenuous activities and contact sports for several weeks.
• Follow-up appointments may be scheduled to monitor the healing process.
• Pain and swelling typically diminish within a few days to weeks.

Alternatives

• Closed treatment with manipulation, if bones are significantly displaced.
• Open surgical intervention in severe cases.
• Pros and cons of alternatives vary based on the severity of the fracture and individual patient factors.

Patient Experience

• The procedure is generally well-tolerated with minimal discomfort.
• Pain management is usually effective with prescribed medications.
• Patients may experience some swelling and bruising, which gradually improves.