We describe a surgical approach for treating chronic osteomyelitis of the proximal phalanx in the hand. The procedure consisted of inserting the second dorsal metacarpal reverse adipofascial flap, including a small amount of interosseous muscle, into the bone marrow space of the phalanx after complete removal of the focus of infection. Two years after the procedure, the patient had full range of motion of the finger with no signs of infection or drainage. This operation resulted in minimal morbidity and a full range of motion of the finger.