Nasal Fracture in Collegiate Gymnast

Background: Collegiate female Gymnast, freshmen. While working on a bar routine during practice, she missed the bar in going from the high bar to the low bar, her arms went under the bar, she turned her head to the left and hit her maxilla and nose. She began to bleed from the right nostril. She had pain in her right. She complained of pain on her right cheek, nose and right eyebrow. She was also complaining or a head ach on the right side. She was informed to not take Advil. Differential Diagnosis. After evaluation it was a suggested diagnosis of a Nasal fracture, another diagnosis was a nasal contusion with a possible nasal fracture without obstruction. After meeting with the physician he was stated, “It is broken and your septum is going to need to be realigned.” The physician was very informative and answered any questions that the athlete had about the procedure. Treatment: She had two view X-rays of her facial bones, which revealed slight lucent line through the left nasal bone, which was not present on the right aspect. She also had soft tissue imaging WNL, which came back with no other abnormalities. The athlete has surgery to fix the fracture she will be held out of practice due to swelling and pain. But will slowly work back into activities. After surgery she was not able to sleep a full night and was still feeling very nauseated and had taken medication for that which made her feel drowsy. She stated that “ it is very painful and I can feel that under my eyes is starting to bruise”, because of the surgery she was not able to blow her nose but felt very stuffed. Uniqueness: Most incidents that occur in gymnastics are happening to the extremities both lower and upper. There are not many cases of fractured nasal bones in the case of a collegiate gymnast. Gymnastics is ranked in the top ten of most dangerous sports. Most of the injuries have been caused by over use and chronic cases where this is more of an acute “fast healing” injury. Conclusions: I feel that this is a different injury and because of the nature of it, it is important to remember that not all injuries are going to be chronic and you need to be prepared for acute trauma aswell.