Crooked nose causes are typically due to mechanical trauma to the side of the nose or a direct head-on crushing injury. Mechanical trauma can follow after altercations resulting from a punch to the side of the nose, sports injuries involving either a side or front impact from a ball, bat, racquet, club, etc, or motor vehicle accidents typically a direct hit.
Crooked nose causes follow breaking of the nasal bones that can occur from either the side or directly from the front. All of the above trauma forces will result in the breaking of the nasal bones that are very thin and friable. The nasal bones are composed of two 1 to 2 mm thick bones that span from the lateral maxillary bones to meet in the middle.
Crooked nose causes resulting from a direct blow will typically result in a crushing injury and depicted by a saddle nose deformity. Even with a saddle nose deformity, there will be a small component of crooked nasal deformity as one nasal bone buckles more than the other. The more common crooked nose causes follow a side impact which will literally buckle the nose to the contralateral side.
Since the cartilage tissues are more pliable, the cartilage supportive structures will typically be spared from injury. Any cartilaginous injuries tend to occur at the bony and cartilaginous junctions, where the bony components get dislodged from their attachment points.
Crooked nose causes the nasal bones to become displaced one way or the other. Typically the nasal bones will shift at their inferior aspect at the junction of the upper nasal bones and the mid nasal cartilages. This results in a maximal displacement of the nasal dorsum at the nasal midpoint.
Crooked nose causes immediate compromise of the breathing as the internal nares tunnels to become constricted. Typically, the nares on the side of the impact are more constricted than the contralateral side.
Regardless of crooked nose causes, the treatment will require realignment of the nasal dorsum. This must be achieved acutely within the first week or in delayed fashion within the first month.
Please appreciate a 17-year-old male who had an injury following a soccer game and had rhinoplasty, septoplasty, turbinectomy to correct his deformity with immediate reduction.