Mild nasal fractures need nothing more than ice and pain killers, while breaks with severe deformities or associated lacerations may need further treatment, such as moving the bones back into alignment and antibiotic treatment.Treatment aims to repair the faces natural bony architecture and to leave as little apparent trace of the injury as possible. Fractures may be repaired with metal plates and screws commonly made from Titanium. Resorbable materials are also available; these are biologically degraded and removed over time but there is no evidence supporting their use over conventional Titanium plates. Fractures may also be wired into place. Bone grafting is another option to repair the bones architecture, to fill out missing sections, and to provide structural support. Medical literature suggests that early repair of facial injuries, within hours or days, results in better outcomes for function and appearance.Surgical specialists who commonly treat specific aspects of facial trauma are oral and maxillofacial surgeons, otolaryngologists, and plastic surgeons. These surgeons are trained in the comprehensive management of trauma to the lower, middle and upper face and have to take written and oral board examinations covering the management of facial injuries. Prognosis and complications
By itself, facial trauma rarely presents a threat to life; however it is often associated with dangerous injuries, and life-threatening complications such as blockage of the airway may occur. The airway can be blocked due to bleeding, swelling of surrounding tissues, or damage to structures. Burns to the face can cause swelling of tissues and thereby lead to airway blockage.
Several mutations were found in the protein O-Mannosyltransferase POMT1 and POMT2 genes, and one mutation was found in each of the fukutin and fukutin-related protein genes. Another gene that has been linked to this condition is Beta-1,3-N-acetylgalactosaminyltransferase 2 (B3GALNT2). Diagnosis
Laboratory investigations usually show elevated creatine kinase, myopathic/dystrophic muscle pathology and altered α-dystroglycan. Antenatal diagnosis is possible in families with known mutations. Prenatal ultrasound may be helpful for diagnosis in families where the molecular defect is unknown. Prognosis
No specific treatment is available. Management is only supportive and preventive. Those who are diagnosed with the disease often die within the first few months of life. Almost all children with the disease die by the age of three. Eponym
WWS is named for Arthur Earl Walker and Mette Warburg (1926-2015), a Danish ophthalmologist. Its alternative names include Chemke’s syndrome and Pagon’s syndrome, named after Juan M. Chemke and Roberta A. Pagon. References
Further reading
HARD syndrome; Walker–Warburg syndrome; Chemke syndrome; COD (cerebroocular dysgenesis) at NIHs Office of Rare Diseases


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