Objective:To investigate the prevention and treatment for deviation of costal cartilage dorsal onlay grafts in rhinoplasty.Methods:From January 2010 to October 2020, a total of 588 patients (83 male cases, 505 female cases, age range from 25 years to 55 years, 32±4 years in average) accepted costal cartilage rhinoplasty in Shenzhen Mylike Medical Plastic Aesthetic Hospital. During the operation, various methods were used in the process of catilage selection, water bath, sculpture, treatment of nasal dorsal, graft fixation and fascial modification to prevent and treat the deformation and displacement of the costal cartilage dorsal onlay grafts.Results:The immediate postoperative photograph of 588 cases showed that costal cartilage dorsal onlay graft was put on the middle of dorsum. After a follow-up period of 396 cases from 6 to 60 months, the average follow-up period was 12.1 months, there were 44 cases happened with the deviation of dorsal onlay grafts, and deviation was managed after the second rhinoplasty surgery. There was no prolonged function sequela such as ventilation dysfunction, abnormal sensation, or hyposmia occured. 362 cases were satisfied with the aesthetic effect.Conclusions:It is particularly important to grasp the principles of managing costal cartilage in rhinoplasty and to learn how to prevent and treat postoperative complications of costal cartilage dorsal onlay graft.

Objective:To explore the surgical treatment of lateral condylar fracture of the humerus combined with lateral dislocation of the elbow in adults.Methods:A retrospective study was conducted to analyze the 8 patients who had been treated at Department of Orthopaedic Trauma, Zhengzhou Orthopaedic Hospital for lateral condylar fracture of the humerus combined with lateral dislocation of the elbow from June 2020 to June 2023. There were 3 males and 5 females, with an age of (50.1±12.3) years. All the lateral condylar fractures of the humerus combined with lateral dislocations were treated by open reduction and internal fixation after swelling subsided. Flexion and extension of the elbow and rotation of the forearm were recorded at the last follow-up. Mayo elbow function score (MEPS) was used to evaluate the functional recovery of the elbow.Results:Elbow dislocation was corrected in 2 patients after rectification, but the elbow subluxation still existed because the displacement of the humeral lateral condyle was not reduced. The elbow dislocation still existed in 6 patients because it was difficult to maintain the correction of the dislocation after manual reduction. Follow-ups were conducted for 12.0 (12.0, 18.8) months. At the last follow-up, the flexion-extension was 85.6°±20.3°, rotation 133.1°±24.0°, and MEPS (91.9±8.0) points. The joint stability was significantly improved in the 8 patients compared with that before operation. Obvious pain was reported in none of the patients, and their joint limitation was acceptable.Conclusions:In adults, lateral condylar fracture of the humerus combined with lateral dislocation of the elbow is rare in clinic. Surgical treatment of the condition can achieve satisfactory clinical outcomes, but elbow dysfunction and limited rotation of the forearm may occur in the affected limb.