Comparison of closed reduction alone versus primary open repair of acute nasoseptal fractures

Robert J DeFatta, Yadranko Ducic, Robert T Adelson, Peter R Sabatini
Journal of Otolaryngology—Head & Neck Surgery 2008, 37 (4): 502-6

OBJECTIVE: Nasoseptal injuries have traditionally been treated via closed reduction. Historically, the high incidence of postreduction deformities has led some surgeons to consider alternative approaches to obtain superior results. Here we compare simple closed reduction versus primary open repair of the nasoseptal fracture.

STUDY DESIGN: This was a prospective study of 40 consecutive patients treated with simple closed reduction of their combined nasal bone and septal fracture versus 40 patients treated with closed reduction of their nasal bone fracture and open treatment of the septum. Group outcomes were then compared.

RESULTS: In the closed reduction group, 60% had significant postoperative septal deviation, whereas only 12.5% suffered from residual septal deformity in the open group. This resulted in a statistically significant reduction (p < .01) of patients requiring a second operation to formally address the septum.

CONCLUSION: By addressing the septum through an open approach, a statistically significant reduction in the number of patients requiring revision rhinoplasty was achieved.

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