Nose Laceration with Fracture (Child)

Your child has a cut (laceration) on the nose. The nose is also broken (fractured). It may be a minor hairline crack or a major break with the parts pushed out of place. Cuts on the nose can cause redness, swelling, and bleeding. A broken nose can cause pain, swelling, nasal stuffiness, and bruising around the eyes.

Shallow cuts may be closed with strips of surgical tape or skin glue. Deeper cuts may be closed with stitches. To stop bleeding, packing (gauze or other materials) may be placed inside the nose. A splint may be placed inside or over the nose to hold the fracture in place. A minor fracture will likely heal with no other treatment. A fracture that changes the shape of the nose may require straightening (reduction). It may be best to wait to do the reduction until swelling has gone down. A severely broken nose may need other treatment, such as surgery. 

Depending on the cause of the injury and your child’s immunization status, your child's healthcare provider may give him or her a tetanus shot.

Home care

  • Your healthcare provider may prescribe an antibiotic. This is to help prevent infection. Follow all instructions for giving this medicine to your child. The child should take the medicine as directed until it is gone or you are told to stop. You should not have any left over.

  • The healthcare provider may prescribe medicines for pain. Follow instructions for giving them to your child. Don't give your child medicines that haven't been discussed with the healthcare provider.

  • Follow the healthcare provider’s instructions on how to care for the cut.

    • Wash your hands with soap and warm water before and after caring for your child. This helps prevent infection.

    • If a bandage was applied and it becomes wet or dirty, replace it. Otherwise, leave it in place for the first 24 hours. Then change it once a day, or as directed.

    • If stitches were used, clean the wound daily. After removing the bandage, wash the area with soap and water. Use a wet cotton swab to loosen and remove any blood or crust that forms. After cleaning, pat the wound dry. Reapply a fresh bandage. Your child may bathe as usual. Don't soak the area in water (no swimming) until the stitches are removed.

    • If surgical tape was used, keep the area clean and dry. If it becomes wet, blot it dry with a towel.

    • If skin glue was used, keep the wound clean and dry. Don't use soaps, lotions, or ointments on the wound area. Don't scrub the wound. After your child bathes, pat the wound dry with a soft towel. Don't let your child soak the wound in water (no swimming). Keep your child from scratching, rubbing, or picking at the skin glue. Don't apply liquids (such as peroxide), ointments, or creams to the wound while the glue is in place.

  • Most facial skin wounds heal without problems. But an infection sometimes occurs even with correct treatment. So always watch for the signs of infection. (These are listed in "When to get medical advice" below).

  • To help ease pain and swelling, have your child use an ice pack. Place it gently on the nose for 20 minutes every 1 to 2 hours the first day. Continue with ice packs 3 to 4 times a day for the next 2 days, then as needed. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Don’t put ice or an ice pack directly on the skin.

  • Don't give your child hot liquids for the first 2 days after treatment. Hot liquids in the mouth can widen (dilate) blood vessels in the nose and cause bleeding.

  • Tell your child not to blow their nose for the first 2 days. This can cause the nose to start bleeding again.

  • Keep your child from contact sports for at least 6 weeks.

Follow-up care

Follow up with your child's healthcare provider as advised. Be sure to return to have the stitches removed as directed. Ask your provider how long stitches should stay in place. If surgical tape closures or skin glue were used, you may remove them yourself when your provider advises if they have not fallen off on their own. 

If you have been referred to a specialist to have your child's nose examined or reduced, make an appointment as soon as possible.

Special note to parents

Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done for your child's protection. Please try to be patient and not take offense.

Note about concussion

Because the injury was to your child's head, it is possible that he or she could have a concussion (mild brain injury). Symptoms of concussion can show up later. For this reason, be alert for signs and symptoms of a concussion. Get emergency medical care if any of these occur over the next hours or days:

  • Headache

  • Nausea or vomiting

  • Dizziness

  • Sensitivity to light or noise

  • Abnormal sleepiness or grogginess

  • Trouble falling asleep

  • Personality changes

  • Vision changes

  • Memory loss

  • Confusion

  • Trouble walking or clumsiness

  • Loss of consciousness (even for a short time)

  • Inability to be awakened

When to get medical advice

Call your child's healthcare provider right away if any of these occur:

  • Stitches come apart or fall out, or surgical tape closures fall off before 5 days

  • Bleeding from the nose that is not controlled by pinching the nostrils together for 10 minutes

  • Signs of infection, including increasing swelling, pain, or redness around the wound, or pus draining from the wound

  • Fever (see "Fever and children," below)

  • Chills

  • Inability to breathe from both sides of the nose after swelling goes down

  • Sinus pain

  • Repeated vomiting

  • Changes in vision

  • Leaking of clear fluid from the nose (sign of a more serious problem)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4°F (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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