Nasal Fractures: What does the literature say?

Legal Aspects in Nasal Fractures

Rhinology, 1991

ABSTRACT

A criminal act is involved in a high percentage of cases of nasal fracture, and exact medical information describing the damages found is mandatory for the criminal court. It is necessary, that the medical information are obtained from the ENT-department, where the patient is treated, as the information obtained from the [emergency] department has a too low degree of truth in the establishment of the diagnosis. The statement should include information on the treatment given, as linear fractures in good position requiring no treatment may be classified legally as an offence against the person rather than as a bodily harm. X-ray examination of the nose in cases of nasal fracture gives a much too high number of false positive and false negative results to have any legal value, and, having no medical value as well, they should not be taken unless for scientific purposes.

Content

…old nasal fractures heal by ossification in only 50%, while the remainder heal with more or less fibrosis connecting the fragments thus being visible by X-ray examination for the rest of the life….

…a linear nasal fracture in good position is diagnosed and no treatment is indicated. The frequency of this findings is 30-59% [sic]…

Medico-legal and ethical aspects of nasal fractures secondary to assault: do we owe a duty of care to advise patients to have a facial x-ray?

Journal of Medical Ethics, 2013

ABSTRACT

Guidelines advise that x-rays do not contribute to the clinical management of simple nasal fractures. However, in cases of simple nasal fracture secondary to assault, a facial x-ray may provide additional legal evidence should the victim wish to press charges, though there is no published guidance.

Content

…Bolam establishes the principle that if a responsible body of opinion exists that nasal fractures can be diagnosed and managed on clinical findings alone this should constitute valid evidence for the courts…It may be deemed unethical to expose a patient to radiation to prove a point for law (and possible litigation) where there is no medical benefit…

For our newsletter and blog this month we are discussing nasal fractures. The blog topics for this month are:

• What is a nasal fracture, really? (5/1/15)
• Does the patient in your case have a nasal fracture? (5/8/15)
• Nasal Fractures: What does the literature say? (5/15/15)
• Legal Implications (5/22/15)

Note: To see all posts in this topic, click here