Although nasal fractures represent about half of facial fractures in paediatric age, the frequency is much lower in children under 3 years of age, in whom the cartilage component of the nasal skeleton prevails (with poor development of the cortical bone component) and there is reduced emergence from the facial profile of the nasal pyramid. In trauma the septum is mainly injured, fractured longitudinally in the anterior portion or displaced, as is common in neonatal fractures. The diagnosis is clinical while the evaluation with an X-ray is not very reliable due to the absence or incomplete ossification and the prevalence of cartilage and soft tissues, with paranasal sinuses that are often small and poorly pneumatized. Unnecessary X-rays expose patients to ionizing radiation, including high costs for society and environmental harm.
In recent years, ultrasound has been used as a complementary tool in cases of uncertain clinical presentation, showing a high negative predictive value for identifying nasal fractures in children. Although CT remains the optimal imaging method for detailed assessment, it is not used routinely due to factors such as radiation exposure and the need for cooperation or sedation in younger patients.

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