Enhanced SJ Tripod Suspension Technique: Achieving Comfort and Predictable Outcomes in Severe Nasal Fracture Treatment

Abstract

Introduction

Managing comminuted and complicated nasal fractures is challenging because it requires obtaining both functional and cosmetic satisfaction.

Objectives and Hypothesis

This research examines patient satisfaction with the closed reduction strategy paired with the use of SJ tripod suspension and splintage technique for severe nasal fractures. Our hypothesis is that proper duration of internal and external splintage is the key to satisfying results.

Study Design

Case series.

Methods

A total of 186 consenting individuals presenting over 10 years with severe nasal fractures underwent this technique. The average duration of splintage was 10 days. Patients assessed their satisfaction using a visual analog scale.

Results

Out of the total 186 cases, 183 cases were highly satisfied with both functional (98.91%) and cosmetic (91.39%) outcomes.

Conclusion

The tripod suspension and splintage approach is an effective and comfortable technique for the closed reduction and splintage of comminuted and complicated nasal fractures.

Keywords

closed reduction - long term splintage - tripod suspension - severe nasal fractures

Publication History

Accepted Manuscript online:
28 April 2025

Article published online:
09 May 2025

• References

• 1 Ondik MP, Lipinski L, Dezfoli S, Fedok FG. The treatment of nasal fractures: a changing paradigm. Arch Facial Plast Surg 2009; 11 (05) 296-302
• 2 Rohrich RJ, Adams Jr WP. Nasal fracture management: minimizing secondary nasal deformities. Plast Reconstr Surg 2000; 106 (02) 266-273
• 3 Drezner DA. Thermoplastic splint for use after nasal fracture. Otolaryngol Head Neck Surg 1994; 111 (01) 146-147
• 4 Ahn MS, Maas CS, Monhian N. A novel, conformable, rapidly setting nasal splint material: results of a prospective study. Arch Facial Plast Surg 2003; 5 (02) 189-192
• 5 Wurtele P. Fixing external nasal splint with tegaderm i.v. dressing. J Otolaryngol 1990; 19 (01) 79
• 6 Matti BA, Nicolle FV. Use of orthoplast as nasal splint. Br J Plast Surg 1986; 39 (03) 414-416
• 7 Anastassov GE, Payami A, Manji Z. External fixation of unstable, “flail” nasal fractures. Craniomaxillofac Trauma Reconstr 2012; 5 (02) 99-106
• 8 Joshi SJ, Mishra G, Panchal NK. Tripod suspension and stabilisation: an innovative splintage technique for closed reduction of comminuted and compound fractures of the nasal bones. Eur J Plast Surg 2016; 39: 85-92
• 9 Hunter BG, Tasman AJ. Suspension technique for unstable nasal bones. JAMA Facial Plast Surg 2019; 21 (05) 460
• 10 Yu SS, Cho PD, Shin HW, Rhee SC, Lee SH. A comparison between K-wire splinting and intranasal gauze packing in nasal bone fracture. J Craniofac Surg 2015; 26 (05) 1624-1627
• 11 Choi MH, Cheon JS, Son KM, Choi WY. Long-term postoperative satisfaction and complications in nasal bone fracture patients according to fracture type, site, and severity. Arch Craniofac Surg 2020; 21 (01) 7-14
• 12 Staffel JG. Optimizing treatment of nasal fractures. Laryngoscope 2002; 112 (10) 1709-1719
• 13 Pollock RA. Nasal trauma. pathomechanics and surgical management of acute injuries. Clin Plast Surg 1992; 19 (01) 133-147
• 14 Wong CH, Daniel RK. Immediate functional and cosmetic open rhinoplasty following acute nasal fractures: our experience with Asian noses. Aesthet Surg J 2013; 33 (04) 505-515
• 15 Sathyendra V, Darowish M. Basic science of bone healing. Hand Clin 2013; 29 (04) 473-481