Main Theme: Rhinology
Introduction:
Paediatric nasal fractures are the most common facial fractures in children and require timely assessment to ensure good cosmetic and functional outcomes. ENT UK recommends specialist review within 3–7 days of injury. In children, fracture healing occurs more rapidly than in adults, making earlier intervention essential to maximise the opportunity for successful fracture reduction 1. This audit evaluated compliance with national guidance and identified opportunities to improve the referral pathway to ENT.
Methods:
A retrospective audit was conducted of children referred to the paediatric ENT emergency clinic with suspected nasal fractures between June and September 2025. Data collected included attendance, fracture confirmation, timing of referral and assessment, and subsequent management.
Results:
Forty-three children were referred, of whom 34 attended clinic. Fourteen had confirmed nasal fractures. Nine underwent fracture reduction (seven under local anaesthetic and two under general anaesthetic), one declined treatment, and four were unsuitable for manipulation because they presented outside the optimal treatment window. The mean interval from injury to referral was five days. Only 12 patients were assessed within seven days of injury, while the longest delay was 60 days. 9 represented to the emergency department following their initial attendance.
Conclusion:
This audit identified significant delays within the referral pathway, resulting in poor compliance with national guidance and missed opportunities for fracture manipulation. To address this, a patient initiated follow up pathway with QR linked patient information has been developed to improve awareness, facilitate timely specialist review, reduce delays, and improve service efficiency.
References
1. ENT UK. Nasal trauma/fracture [Internet]. London: ENT UK; [cited 2026 Jul 7]. Available from: ENT UK Nasal Trauma Guideline