A sliding flap to cover dorsal skin defects over the proximal interphalangeal joint

Conventional transposition flaps may produce a conflict between the line of maximum tension across the flap and the line of desired maximum extensibility necessary for the achievement of a full range of proximal interphalangeal joint flexion. A sliding transposition flap is described which has the advantage that it has less tension in its transposed position than it has in its normal resting position and that there is no conflict between the pivot point line and the desired production of proximal interphalangeal joint movement. This is possible because of the presence of a large dog-ear which provides a longitudinal skin redundancy exactly where it is needed. The flap is obliquely placed and is usually an axial pattern flap and inherently safe.