Nasal and nasoethmoidal-orbital fractures: A continuum of injury

The nasal bones are the most commonly fractured segment of the facial skeleton; over 50% of fractures from blunt maxillofacial trauma are sustained in this area (1,2). The prominent position and the relatively poor resistance offered by the osseocartilaginous framework predispose the nasal pyramid and underlying septum to varying degrees of comminution and displacement. The injury that results is related to the mechanism of injury and patient variables, including age and tissue resilience. These factors are in dynamic interplay with the direction, magnitude and concentration of force applied over the facial skeleton (3-5). These latter parameters primarily dictate not only the extent of local nasal injury, but also the involvement of the ethmoidal-orbital complex and adjacent bony structures in the ultimate fracture pattern.