The latter is done in an oblique direction. See [Fig. 371]. The septal section is made to include the bone strip.
The bridge of bone holding the flap at its inferior end was now broken, leaving, however, the periosteum as part of the pedicle hinge.
The whole flap thus outlined was rotated downward into position and sutured, as shown in [Fig. 372].
The margins at the base intended to form the subseptum were sutured behind the osseous structure, or, in other words, were doubled inward and fixed by suture. The bony strip was broken at the proper point to give prominence to the lobule.
The margins for the nostrils were turned inward and doubled on themselves, and sutured with silk.
Rubber tubes were left in the nares, for drainage and to keep them distended.
Rotter Method.—The frontal flap is made in the shape shown in [Fig. 373], containing a section of the frontal bone and its periosteum. The width of the flap is about three and a half centimeters wide.
This flap is turned downward so that its raw surfaces look outward.
Owing to the loose adherence of the bony section to the skin flap, he allows the raw bone surface to granulate over for four weeks, to fix it more solidly to the soft parts.
The bone plate is then sawn into three sections made by two vertical incisions, made as shown in the illustration.