Virtual Patients - Rhinology - Nasal injury

A 21-year-old man is allegedly assaulted on Wind street at 2 am on a Saturday morning. He sustains a single punch to the nose with no loss of consciousness. He suffers an initial epistaxis from both nostrils that lasts around 20 minutes and then stops with first aid.

 

The next morning after sobering up he is concerned with his appearance and new blocked sensation inside his nose.

On examination, he has a grossly swollen nose and it is difficult to assess whether the nasal bones have deviated. As a very thorough & vigilant doctor, you examine inside the nose and are confronted by the following appearance.

Question

 

What is the spot diagnosis?