A 48-year-old, right-handed man sustained a degloving injury to the middle finger. He lost the bone distal to the distal part of the middle phalanx and the soft tissue distal to the proximal interphalangeal (PIP) joint. We planned to use two regional flaps to reconstruct the wide skin defect. To cover the volar loss of skin, the cross finger flap from the dorsal index was selected. For the dorsal loss of skin, we devised an extended dorsocommissural flap, which was harvested with the pivot point at the radial neck of the proximal phalanx as an axial pattern flap nourished by the dorsal metacarpal artery between the second and third metacarpals. The flaps survived after surgery. The patient returned to work three months after the injury. His Quick Disabilities of the Arm, Shoulder, and Hand score was 6.82. The extended dorsocommissural flap from the dorsum of the hand with the cross finger flap from the neighboring finger was suggested to be effective to cover the wide circumferential loss of skin in the distal region of the finger.
