Any significant central midface trauma should be considered highly suspicious for the presence of a nasal bone fracture. A direct impact is most likely to cause a fracture because there is no soft tissue to dissipate the force of the blow. The pathomechanics of the resulting fracture vary according to the site, direction, and intensity of impact, as well as the characteristics of the bone that is struck. In younger patients, bones are denser and more elastic, whereas in older patients, bones are less dense and more brittle.
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