The use of metatarsal bone grafts in the treatment of saddle nose deformities

The results from segmental fourth metatarsal bone reconstruction of significant nasal dorsal defects are described. Solid bone graft reconstructions frequently lead to an unnatural hardness of the nasal tip. Rib cartilage reconstructions are pliable and soft, but pose a problem because they easily undergo warpage. The operation is performed using the open approach. An outer fourth metatarsal bone graft used for the bone component extends at least two-thirds of the dorsum length. It is secured in place with a compression screw and a Kirschner wire. The cartilage component comprises an abbreviated L-strut constructed of septal cartilage. It is slotted into the metatarsal bone in a tongue-in-groove manner and sutured to it through a drill hole in the bone. The dorsal profile is completed in this manner.