Open reduction and interfragment wire fixation of comminuted nasal fractures.

Manual reduction is the first choice for all types of acute nasal fractures; open reduction is the choice for fractures that do not respond to manual reduction or complicated fractures at the base of the nasal pyramid. From 1968 to 1986, 564 cases of nasal fractures were treated at the Department of Plastic and Reconstructive Surgery, Jikei University School of Medicine, Tokyo. Of these, 241 were acute nasal fractures, 52 of which were associated with facial bone fractures. Deviated types of fractures that cannot be correctly repositioned by manual reduction and some depressed fractures often require a surgical approach for reduction and fixation. In our series of 241 patients with acute nasal fractures, 43 (18%) were treated by open reduction and fixed with soft stainless steel wires.