We evaluated the clinical outcomes and treatment course in 8 patients with crush wounds in the dorsal hand that required soft tissue reconstruction. The mechanism of injury was crush injury in 7 cases and degloving injury in 1 case. The average time from injury to soft tissue reconstruction was 9 days (7?12 days) , except in 1 case in which a free anterolateral thigh (ALT) flap was performed 101 days after the initial injury. Free ALT flaps were applied in 7 cases and a reverse posterior interosseous artery flap was applied in 1 case. Four cases (11 affected digits) had complex injuries, including bone and/or tendon injury. In 3 of the 4 cases with complex injuries, 9 digits had severe contracture of the metacarpophalangeal joint with an arc <30 degrees. Complete rehabilitation was not achieved in these 3 cases due to inadequate bone fixation, insufficient debridement leading to infection, and inadequate soft tissue reconstruction. The clinical results of cases without bone/tendon injury were satisfactory when the appropriate soft tissue reconstruction was performed. Severe crush injuries of the bone/tendon often result in severe adhesion and contracture, and early rehabilitation, including adequate bone/tendon reconstruction and soft tissue reconstruction in the metacarpophalangeal joint-flexed position, is essential in such cases.
