A distally based dorsal and triangular tendinous flap for direct access to the proximal interphalangeal joint.

This dorsal approach allows for a large exposure and provides direct access to the PIP joint. A long triangular tendinous flap with a pedicle based on the insertion of the medial band in dissected from the extensor apparatus and lifted up, leaving the intact lateral bands to slip anteriorally, which exposes perfectly the PIP joint. After joint exposure is achieved and surgery accomplished, this flap is firmly sutured in place and the joint immediately allowed to move. Three cases are presented.