This fracturing is made as the flap is still further brought down, as in [Fig. 410].
The flap is now so adjusted that its median bone-lined section will form the median third of the nose, the base being made by folding the flap upon itself, as shown in [Fig. 411].
Fig. 410.—Forming base of nose.
Fig. 411.—Ultimate disposition of entire flap.
Nélaton Method.
The raw surfaces are sutured at their point of coaptation, laterally, and to the margins of the genian flaps.
The frontal wound is brought together by suture as closely as possible, and Thiersch grafts are employed to close any wound still remaining.
The objections to this operation is that of all bone-plate flaps. A flap containing a cartilaginous support taken from the eighth costal cartilage, as previously described, would undoubtedly give the best results.