ABSTRACT
Soft tissue defects that require tendon and skin reconstruction are not uncommon at the hand level. This chapter focuses on reconstructing combined defects at two locations: the dorsum of the hand and the thenar area. In the former, the skin, the tendon and, at times, the bones are destroyed by frictional or crushing forces. A lack of extension at the metacarpophalangeal joint is the main limitation. In the thenar area destruction of the abductor, the opponens and the superficial head of the flexor pollicis brevis by avulsing forces or burns poses a challenge to the hand surgeon as there is a need to restore cover and to re-establish opposition.
