Introduction: Nasal bone fracture is a common facial injury with potential early postoperative consequences, including pain, bleeding, edema, airway symptoms, and residual deformity. Fracture severity may influence these outcomes by reflecting the extent of structural and soft-tissue damage. This study aimed to determine short-term postoperative complications according to nasal bone fracture severity.

Material and methods: This descriptive cross-sectional study of 75 patients at Tabriz University of Medical Sciences in 2024 investigated the association between nasal bone fracture severity and early outcomes. Measured variables included demographics, fracture characteristics, surgical parameters, and short-term complications, including VAS pain score, epistaxis, edema, ecchymosis, and septal hematoma. Data were analyzed using normality testing, t-tests, Mann-Whitney U, and chi-square tests.

Results: Among 75 patients, severe/complex nasal fractures (n = 34) were associated with worse short-term postoperative outcomes than mild/moderate injuries (n = 41). Severe fracture patients experienced longer operations (41.53 ± 11.47 vs. 28.64 ± 8.12 minutes, p < 0.001), higher 24-hour VAS pain (4.85 ± 1.56 vs. 3.42 ± 1.18, p < 0.001), increased moderate/severe edema (61.76% vs. 26.83%, p = 0.002), and more unplanned visits (26.47% vs. 7.32%, p = 0.027). Severe fracture independently predicted early complications (adjusted OR = 3.86, p = 0.020).

Conclusion: Severe nasal bone fractures are independently associated with an increased risk of short-term postoperative complications. Patients with complex fracture patterns experience higher pain levels, more pronounced soft-tissue edema, and greater rates of early residual deformity, leading to more frequent unplanned clinical evaluations. Preoperative severity stratification can identify high-risk cases requiring closer early postoperative surveillance.