Objective:To explore the application effect of skin flap repair in hand fracture with skin and soft tissue injury.Methods:A retrospective analysis of 66 patients with hand fractures and skin and soft tissue defects admitted to our hospital from July 2019 to July 2021 was divided into control group and observation group according to the flap repair method, 33 cases in each group.The control group was treated with dorsal metacarpal flap transplantation, and the observation group was treated with dorsal fascial flap repair and transplantation.The perioperative data, hand function, complications, donor site healing and pain of the two groups were observed.Results:The intraoperative blood loss in the observation group was lower than that in the control group (P<0.05), and the fracture healing time, fracture external fixation time and hospitalization days were shorter than those in the control group (P<0.05). The excellent and good rate of hand function and the good healing rate of donor area were higher than those of the control group, and the incidence of complications and VAS scores at 10 days and 2 months after operation were lower than those of the control group (P<0.05).Conclusions:Flap repair has a good clinical effect in hand fracture with skin and soft tissue defect. Dorsal fasciocutaneous flap transplantation can reduce surgical injury, promote postoperative healing, shorten hospitalization time, improve hand function, and reduce the incidence of complications and postoperative pain.