Clint Dempsey Breaks Nose in Game 2 vs. Portugal in the World Cup

by Dr. Matthew Kaufman

Clint Dempsey’s nasal fracture in game #2 of the World Cup has caused a frenzy over how he will continue to play in upcoming games, and also whether he will be wearing a protective mask to prevent further injury.

Treatment for A Broken Nose Sports Injury

The nose is the most likely bone in the face to be broken and frequently occurs in athletes playing contact sports such as soccer, so Dempsey’s injury is commonplace in his sport. Regardless of whether the injured party is a professional athlete or a member of a youth recreation league, the same questions arise after a nasal fracture:

Do I need surgery? When can I resume play? Do I need to wear a mask?

The answer to the first question depends on both the functional and aesthetic changes that have occurred as a result of the injury. If there are significant disturbances in the ability to breathe through the nose, and an obvious change in the nasal appearance, it is likely that surgical treatment could be necessary. Typically, a comprehensive evaluation of the nose is best done 2-3 days after the injury when some of the early swelling has resolved. This will allow the physician to best determine whether surgery would be indicated, and also to recommend the timing for intervention.

Athletes with nasal fractures, and other types of sports related injuries, will always ask when they can resume play, especially when the problem occurs mid-season. With a nasal fracture it is best to wait at least 7-14 days for early healing to occur. Any earlier, and the athlete could experience nasal bleeding or re-injury even with slight contact.

The use of a sports protective mask can be very helpful to prevent further injury and to allow the athlete to safely resume play after the initial healing period. A mask is something I recommend under these circumstances, or after corrective nasal surgery to avoid postoperative complications in athletes resuming their sport. For Clint Dempsey, his concern regarding the mask is likely whether it will impede his visual acuity and impact his effectiveness. The sports masks are specifically designed to maximize visualization while protecting the nose.

Ultimately, it is the athlete who makes his own decision regarding care, despite the recommendations of the medical professionals. Dempsey understands the possible consequences of resuming early play without a protective mask (re-injury, bleeding, need for surgery, etc.). As a Plastic and Reconstructive Surgeon who has cared for hundreds of nasal injuries, who is also a tremendous supporter of the U.S. Soccer team, I can understand the delicate balance between proper care of a nasal fracture and optimal performance during the peak of the World Cup action. With some luck, Dempsey will resume play with no further injury and the U.S. will continue its advance.

What Playing Sports with a Broken Nose Means

So, what does a broken nose mean in terms of Dempsey’s playing on Sunday? The effects of a nasal fracture can obviously lead to headaches, nasal pain and nasal obstruction. Individually or collectively, each of these symptoms can affect his playing. There’s anti-inflammatory medications and nasal spray, which can help a bit, but the bottom line is if there’s an anatomical problem, he’ll be affected. If he’s not able to breathe through his nose effectively, he is not getting oxygen in an efficient manner. He could be troubled by that. It could affect his stamina. While he may not be running as much as other players in different positions, his job as a forward involves not being physically obstructed. Having headaches and pain may make him less aggressive, or less inclined to put his head into the game. The heat and humid conditions can exacerbate the swelling a little bit, but I’m not so sure that will have a major impact.

What could happen if Dempsey gets hit in the nose again? A mask is meant to absorb some of the blow rather than the nose. But if someone with a broken nose (particularly unprotected) gets hit again, it can cause instability to a nose that has begun to set and heal. It could perhaps also shatter the bone, and result in a comminuted fracture, (a fracture which is splintered), causing multiple breaks.

About the Author – Dr. Matthew Kaufman, MD, FACS

Dr. Matthew Kaufman has the rather rare distinction of achieving board certification in both Plastic Surgery and Otolaryngology- Head and Neck Surgery. This gives him the added expertise necessary to deal with complex cosmetic and reconstructive problems of the head, face and neck. In addition, he has advanced expertise in complex revision rhinoplasty and ethnic rhinoplasty (non-Caucasian rhinoplasty). He has done groundbreaking work in the field of reconstructive plastic surgery, and is the only known expert to perform phrenic nerve surgery. Dr. Kaufman is a partner at The Plastic Surgery Center, the largest plastic surgery practice in New Jersey.