A new approach to nasomaxillary complex type of nasal bone fracture: Clip operation.

PURPOSE: Nasal bone fractures comprise almost 40% of all facial injuries. Most are initially reduced using closed reduction. This study introduces a newly developed method, the clip operation via endonasal approach.

MATERIALS AND METHODS: The operation was performed in these patients by a single surgeon extensively experienced in facial bone fractures. An absorbable mesh plate made into a clip was used for fixation after open reduction via the endonasal approach. No screws were used for fixation. Nasal packing was removed the first day after surgery; aluminum splinting was removed the third week after surgery. Three-dimensional facial computed tomography and cephalolateral radiography were performed preoperatively and postoperatively. Plastic surgeon satisfaction and postoperative complications were assessed.

RESULTS: Fracture relapse was not observed. Reduction status was well maintained. Postoperative complications occurred, with a low final incidence of 1.8% in the third postoperative month. Plastic surgeon satisfaction was very high at 4.58. This operation takes 5-10 min, and is simple to perform. It entails a short hospitalization, and the duration during which nasal packing and aluminum splint are maintained is comparable. Undesirable functional, aesthetic complications and secondary surgery resulting from inaccurate relapse were reduced.

CONCLUSION: The clip operation is a useful technique for correcting nasal bone fractures, especially nasomaxillary complex type.