The thin cross finger skin flap

The cross-finger flap has been used successfully for decades. Traditionally, the flap is elevated in the plane lying superficial to the extensor tendon. This damages the delicate subcutaneous tissues, which are important for the lengthening capacity of the skin of the dorsum of the fingers during flexion and extension. In this report, we present a modification of elevation of the cross-finger flap in a plane superficial to the dorsal veins of the fingers. This modification prevents donor finger complications such as poor graft take, extensor tendon adhesion to the graft and reduced range of finger joint movement and contour deformities. We have used this technique in six digits in four patients with successful results.