Isolated contracture of proximal interphalangeal joint in 71-year-old woman. A, Maximal passive proximal interphalangeal joint extension of 55 degrees. B, Palpable diseased cord and nodule denoted with planned longitudinal incision. C, Cord and digital nerve underlaid with blue plastic markers. D, Distal retraction of digital cord depicting underlying diseased Cleland ligament. E, Pathology pattern. F and G, Z-plasty skin flap design and closure. SEE TECHNIQUE 75.3.