Friendly game of soccer puts nose out of joint

CHECK-UP: In the case of a nose injury it can take two weeks for the bruising to subside

During a friendly football match on St Stephen’s Day I accidentally head-butted an opponent and injured his nose. I still can’t believe I broke his nose.

A fractured nose is the most common facial fracture. It can involve a break in the bone or cartilage over the bridge, in the sidewall, or at the septum – the structure that divides the nostrils of the nose.

Symptoms of a nose injury include blood from the nose, pain and swelling around the nose and bruising around the eyes.

The person may experience difficulty breathing through the nose which may have a misshapen appearance.

If the injury has been caused by blunt force the septum may separate. Where damage occurs to the lining of the septal cartilage, it can result in a collection of blood forming inside the nose.

If this is not drained away it can cause an abscess to form or result in permanent deformity leading to nasal blockage.

In very severe cases it can result in tissue death and collapse of the nose itself.

What first-aid measures should we have taken at the time of the injury?

The first thing to do in this situation is to reassure the injured person and try to keep them, and you, calm. It may not be possible for them to breath through their injured nose so get them to breathe through the mouth.

Lean the person forward in a sitting position in order to keep blood from going down the back of the throat. Apply a cold compress to the nose to reduce swelling.

It is often best to let the injured person hold the compress themselves to avoid excessive pressure on the nose. Under no circumstances should you try to straighten a broken nose.

Medical assessment following a facial injury is imperative. Nose injuries and neck injuries are often seen together because a blow that is forceful enough to injure the nose may be hard enough to injure the neck.

If you suspect the person has a head or neck injury, do not move them but call the emergency services immediately.

Over a week later he still looks terrible. When should the bruising disappear?

It can take up to two weeks for the bruising to resolve and if there is deformity of the nose or septum caused by the trauma, surgery may be required. In future make sure you wear protective headgear while playing contact sports or other outdoor activities.