Female, 34 years old, her right thumb was destroyed from the plane of the carpometacarpal joint by a multiblade saw at work, and the muscle was not open enough to recognize the specific tissue level, the index finger was destroyed from the base of the second metacarpal bone, the skin of the radial side of the middle finger from the PIP to the MP and the proximal tuberosity were missing, the extensor tendon of the finger was missing for about 6 cm, and the dorsal side of the PIP of the ring finger had longitudinal skin cracks, and the extensor tendon of the finger and the joint capsule were open. The vascular nerve bundle of the right thumb stump was severely defective, and the original segmental reconstruction could only be abandoned. After repeated communication with the family, it was decided to perform a free second toe reconstruction of the thumb and reconstruction of the piriformis, interosseous dorsal flap reconstruction of the tiglosus, osteochondral flap reconstruction of the middle finger, tendon anastomosis, repair of lateral collateral ligaments of the interphalangeal joints, and repair of the joint capsule.