Fractures of nasal septum occurs commonly in combination with fractures of nasal bones. Prompt identification of trauma involving nasal septum will help in preventing cosmetic defects in later life. Early reduction of fractures involving nasal bones and septum will go a long way in preventing cosmetic defects involving the nose.
Types of nasal septal fractures:
Nasal septal fractures have been classified into three types. This classification helps in deciding the optimal management modality.
Type I septal fracture:
In this type the fracture line is limited to either cartilage / bony component of nasal septum, The most important feature is that the fracture line does not cross the osseous cartilagenous junction.
Image showing Type I fracture of nasal septum
Type II septal fracture:
In this type the fracture line involves both bony and cartilagenous portions of nasal septum with the fracture line crossing the osseo cartilagenous junction.
Figure showing Type II fracture of nasal septum
Type III septal fracture:
This type of fracture is characterised by multiple fracture lines involving bony or cartilagenous portions of the nasal septum.
Image showing Type III septal fracture
Classification of septal fracture is not complete without assessing whether the septum is dislocated from the nasal spine or not. If the nasal septum is not displaced from the nasal spine then the fracture is classified under the subcategory A and if it is displaced from the nasal spine then it is subclassified under the category B.
If the nasal septum is dislocated from the nasal spine then it should be repositioned and the fracture reduced at the earliest. Before manipulating the nasal septum the nasal bone fracture should be reduced.
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