Nasal fractures are one of the most common facial fractures in the pediatric population. The decision to perform a closed reduction procedure in the operating room is based on factors such as breathing difficulty and external deformity, which are not assessed effectively by x-ray. Plain film x-rays are unable to accurately evaluate nasal fractures given its low sensitivity and specificity, at 72% and 73% respectively. Physical examination is often sufficient to make a diagnosis for children with displaced nasal fractures. Overall, x-rays do not add value to the diagnosis or treatment plan for children with nasal fractures and should not be ordered to avoid their associated costs and radiation exposure.
For more information:
Desrosiers AE 3rd, Thaller SR. Pediatric nasal fractures: evaluation and management. J Craniofac Surg. 2011;22(4):1327‐9. PMID: 21772190.
Mohammadi A, Ghasemi-Rad M. Nasal bone fracture–ultrasonography or computed tomography? Med Ultrason. 2011;13(4):292‐5. PMID: 22132401.
Nigam A, Goni A, Benjamin A, Dasgupta AR. The value of radiographs in the management of the fractured nose. Arch Emerg Med. 1993;10(4):293‐7. PMID: 8110318.