Dorsal chevron flap for exposure of the proximal interphalangeal joint.

We have used a dorsal V-flap, or chevron flap, to expose the proximal interphalangeal joint. A retrospective clinical study of its use in 16 patients over 5 years is presented, including indications, functional return of movement, and complications. Long-term follow-up showed an average range of active movement of 70 degrees (range, 13-84 degrees). Surgical exposure of the joint was better than other dorsal approaches and overall recovery of movement was not significantly compromised. Alternative surgical techniques such as the dorsal longitudinal split, dorsolateral split and palmar approach are compared in a group of 36 cases.