BACKGROUND The aim of the present evaluation was to analyse a large patient population with nasal bone fractures leading to surgical reposition of the nasal bone. Special attention was paid to age summit, the distribution of the seasons, the rate of open compared to closed nasal bone fractures, accompanying injuries, diagnosis and therapy as well as to the postoperative course. METHODS A total of 300 patients was evaluated retrospectively. All patients had been treated between 1999 and 2004 regarding simple and complex nasal bone fractures. Data were analysed with regard to history, age, gender, diagnosis, therapy, results, and complications. RESULTS The average age of the patients was 29.6+/-15.6 years at the time of fracture with clear predominance of the male gender (77%). Another age summit could be observed in patients of >60 years. The main reasons for nasal bone fracture were falls (30%), in elderly patients often caused by cardiac syncopes, and rows (28%). The most frequent findings were deviation of the longitudinal axis of the nose (59%) and traumatic deviation of the nasal septum (50%). 65 patients (22%) had open nasal bone fractures, in 5% of the cases septal hematoma could be observed. CONCLUSION Closed reposition of the nasal bone is the therapy of choice in uncomplicated nasal bone fractures. Special attention has to be paid to the group of patients aged 60 years and older who often suffer from treatment requiring comorbidities. In these cases inpatient treatment must be considered.

The ambivalent consequences of mitochondrial stimulation on cellular activity have been well established. Mitochondria supply the cell with energy through a process of oxidative phosphorylation but thereby generate free radicals, resulting in the accumulation of hydrogen peroxide in the cytoplasm. We have investigated the impact of cellular senescence as well as UV irradiation, on the balance between these two activities.The adenosine triphosphate (ATP) level, DNA and protein synthesis in fibroblasts obtained from donors between 30 and 90 years of age appeared to be significantly influenced by the aging process. Both DNA and protein synthesis could be stimulated by increasing intracellular ATP levels. In‐vitro senescent fibroblasts showed a reduction in the level of ATP as well as a shift in mitochondrial membrane potential. At the same time, there was an increase in intracellular hydrogen peroxide with increasing population doubling, indicating a clear dysfunction of the metabolic machinery in the mitochondria of senescent cells. To counteract this degradation of the energy pool, we treated cells with creatine, which is known to restore the pool of phosphocreatine in the mitochondria. Creatine treatment significantly increased cell survival after UV exposure, stimulated the repair of UVB‐induced DNA damage in keratinocytes and caused a significant reduction in the number of sunburn cells in a UVB‐exposed reconstituted skin model. These results clearly indicate that restoration of the energy pool in mitochondria increased cellular self‐defense mechanism. These data show the important role played by the mitochondrial energy metabolism on the aging process, and indicate a possible therapy that can be used to counteract this negative effect. Treatment with creatine seems to provide the necessary boost to the cellular metabolism, which leads to an induction of a significant amount of protection and repair to human skin cells.