The Minnesota Timberwolves are in a health crisis.
It’s an epidemic – a surge in a particular kind of ailment that, while it isn’t communicable, is concerning on the Wolves roster. Since training camp began a little over a month ago, 17.65% of their roster has suffered a nose-related injury. Donte DiVincenzo was the most recent victim on Saturday night during Minnesota’s 122-105 road win over the Charlotte Hornets.
Minnesota’s spree of broken noses is more coincidental than actually related. However, with DiVincenzo’s recent injury, it warrants a closer look at what it entails, especially given the gruesome nature of his break.
A broken nose is no joke. It’s a break to the nasal bone (yes, this is the medical name), located just above the bridge of the nose. If you feel your nose, starting at the bottom by the nostrils and moving up, you’ll notice there is quite a bit of give and flexibility in the bottom portion. However, as you get to the bridge, the give disappears. That’s where it transitions from cartilage to bone.
It’s important to note that cartilage cannot break. Instead, it tears. Therefore, a nose can only really break at the bony portion. The nasal bone is effectively a plate of armor that covers the more important bits of the interior of the nose, like cranial nerves. Whereas the cartilage, much like the ears, is more of a functional addition to the human body, enhancing a person’s ability to smell.
Typically, trauma causes a broken nose. In DiVincenzo’s case, it was a firm smack to the face. However, for others, it might be an air bag deployment, a clumsy fall, or getting punched in a 1980s bar-related comedy.
The experience is exceptionally painful because the facial nerves transmit signals to the brain. The nose can become misshapen, and a bloody nose (epistaxis in medical jargon) almost always follows. Next comes the swelling as internal blood vessels break. A broken bone can cause a skin tear and external bleeding, as in DiVincenzo’s case.
The risk of a deviated septum is the biggest concern with a broken nose. That’s where the fracture moves the septum (the wall dividing the internal nostrils) to one side or the other, making the nasal passage smaller and causing breathing issues.
In this case, surgery is needed to fix the septum so that the person’s breathing can return to normal. A secondary concern is cartilage tearing in the lower nose, which can also cause lifelong breathing problems and potential disfigurement. For this, plastic surgery is often required to fix it.
A broken bone typically needs to be “set.” That’s a process in which a physician manually moves the nasal bone back in place. It sounds as awful as it is in reality. As a nasal bone is like a plate of armor, I liken it to a completed puzzle: everything fits where it belongs. Then, when a break occurs, liken it to a puzzle piece being removed. Therefore, setting the nose is the process of sliding the puzzle piece back into place and pushing it in.
As you can imagine, the process is painful. However, after the nose is reset, there is a noticeable decrease in overall pain as the bone is back where it belongs. Thankfully, most patients get local anesthesia to ease the process. The nose is sometimes packed with absorbent material dispensed by a device called a Rhino rocket, which places the material deep in the nose. (We saw DiVincenzo with a packed nose Monday night.) Medical providers do that to help with the bleeding and stabilize the break by allowing the packing to hold the nasal bone in place.
From there, healing a broken nose is fairly simple. The best way to manage nosebleeds is to ice the area when they occur, keep Vaseline on hand for the nasal passages, and – this is crucial – not pick at scabs inside the nose. Swelling and black eyes can be managed with ice, as the head is located above the heart. The swelling usually dissipates fairly soon after the break is reset. Finally, avoiding contact with the broken area is key.
Medical providers are unable to apply a cast to the nasal bone. However, just like with a broken arm, the bones take time to heal, and every bump to the area risks refracturing the bone. However, unlike an arm, there aren’t muscles connected to the nose in the same way. Therefore, it doesn’t need to be immobilized in the same way, but some athletes wear a face mask.
The face mask distributes the blow that may reach the nose. Meanwhile, a direct hit could fracture the nose or cause it to slide out of place. The mask takes the force and spreads it to the cheekbones and forehead, while directing most of it away from the nose. Depending on the fracture, the mask may need to be worn for a couple of weeks during activity, and for months in some cases. Rip Hamilton broke his nose several times playing for the Detroit Pistons in the 2000s and famously decided to wear a mask for the rest of his career.
However, the mask has some downsides. Visibility can be compromised, and they are pretty uncomfortable to wear. Also, a bump to the cheek or head will spread that pressure. Some can fall back onto the nose, making the mask itself quite painful to wear.
DiVincenzo’s mask didn’t seem to affect his performance against the Brooklyn Nets; he made a season-high six three-pointers. Minnesota’s broken noses have affected its roster, with Rocco Zikarsky now wearing a mask in the G league, and Rob Dillingham masked for the Wolves bench. DiVincenzo adds a mask to the starting lineup.
Let’s just hope the extent of the broken-nose epidemic has run its course and no one else suffers the painful injury this season.