[Management of extensive avulsion injury of the hand]

The case of a 25 years old industrial worker is reported, who suffered an extensive avulsion of his left hand in a rubber roller injury. The middle and ring fingers hand to be amputated. The skin loss was covered simultaneously by an axillary pedicled flap for the thumb, two pedicle flaps from the upper arm for the index and small fingers and split thickness skin grafts for the dorsum of the hand. In a second stage, sensation of the tips of thumb and index finger was restored by two innervated full thickness skin grafts from the dorsum of the foot.