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Crossed Finger Flap

- See:
      - Soft Tissue Replacement in the Hand
      - Finger Tip Injuries

- Discussion:
    - crossed finger flaps can be used to cover finger tip injuries w/ excessive loss of volar pulp tissue;
    - rectangular flap is raised from 3 sides of the dorsal surface of middle phalanx of the adjacent finger;
          - typically the flap is based on the lateral side of the adjacent digit, but the flap can also bebased proximally (in order to raise a flap from 
                 the thumb to the radial side of the index finger);
          - flap is harvested thru the subcutaneous tissue and down to (but not thru the underlying epitenon);
          - by cutting Cleland's ligament, the flap will extend 20% longer;
    - flap is swung outward on its hinge and is sutured in place;
    - full thickness graft is sutured to the hinge of the primary defect;
    - flap is divided within two weeks, in order to avoid finger stiffness

The cross-finger flap. An established reconstructive procedure.

An innervated cross-finger flap for fingertip reconstruction.