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Journal of Trauma and Injury 2014;27(4):95-100.
Practical Approach to the Diagnosis of Pediatric Nasal Bone Fractures
Yulkok Lee, Sungchan Oh, Sukjin Cho, Hyejin Kim, Taekyung Kang, Seungwoon Choi, Hanbin Yoo, Seokyong Ryu
Department of Emergency Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea. scoh@paik.ac.kr
소아 환자의 코뼈 골절 진단을 위한 실제적 접근
이율곡, 오성찬, 조석진, 김혜진, 강태경, 최승운, 유한빈, 류석용
인제대학교 의과대학 상계백병원 응급의학교실
Received: 8 May 2014   • Revised: 10 June 2014   • Accepted: 10 June 2014
Abstract
PURPOSE
Nasal bone fractures are the most common childhood facial bone fractures, with an incidence of about 39%. While taking a nasal bone x-ray is a common modality used in the emergency department, reports have expressed concerns with its low sensitivity and low specificity. Our study was aimed at comparing accuracy of physical and x-ray examination with that of facial bone computed tomography (CT).
METHODS
Electronic medical records (EMR) were retrospectively reviewed for patients under the age of 15 who visited our emergency department from January 2010 to December 2011with a chief complaint of nasal pain due to trauma and who had also undergone a nasal bone x-ray and facial bone CT. Patients who had not taken facial bone CT, who had been transferred, and who did not have EMR were excluded. We divided the patients into 2 groups, those who had nasal bone fractures and those without a fracture on their facial bone CT. We analyzed other parameters such as age, sex, and type of fracture to find statistical differences between the two groups.
RESULTS
A total of 209 patients were included. The patients with nasal bone fractures on their facial bone CT were older, and their traumas were more violent. Ten patients who had apparent nasal bone fractures on their facial bone CT had no definite signs of a fracture on their plain x-ray.
CONCLUSION
Though facial bone CT is an effective modality in detecting nasal bone fractures, in evaluating younger patients suspected of having nasal bone fractures, prudent use of facial bone CT is needed to reduce unnecessary exposure to radiation.
Key Words: Nose; Fracture; Computed tomography; Pediatrics


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