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Differential Diagnosis
• Displaced maxillary spine fracture
• Le Fort fracture
• Pterygoid plate fracture
• Temporal bone fracture
• Zygomaticomaxillary complex fracture

Diagnosis
The patient suffered a displaced maxillary spine fracture.

Learnings

  • The maxillary spine is a focal anterior bony protrusion in the midline at the bottom of the nose
  • The fracture can occur through the different part of the maxillary spine and could be displaced or nondisplaced
  • This fracture is typically diagnosed on the lateral view of the face and CT studies
  • The fractures could be posttraumatic or postsurgical
  • Localized pain and numbness of the upper lip and teeth are the usual symptoms

Pearls for Urgent Care Management and Consideration for Transfer

  • All maxillary spine fractures heal
  • Displaced fractures may be treated surgically to prevent deformity of the base of the nose
A 20-Year-Old Male with Nasal Pain Following an Injury