因遭機器壓碎而導致大範圍手掌皮膚缺損合併組織喪失的傷害，外科處置方式通常透過皮瓣移植以重建受傷部位。然而患者常因在接受皮瓣移植後，手部會長期的連接在轉移處導致長期制動，進而提高日後復健療程的複雜度。若這類病患能盡早進行相關的職能治療介入，則應可避免因制動持續時間過長而出現相關併發症。在本篇個案報告中，以一位手部嚴重壓碎傷且成功接受皮瓣移植治療傷口的個案為例，探討職能治療早期介入對改善個案手功能的臨床效益。結果發現經過半年的治療後，個案恢復的情況良好，基本日常生活活動可完全獨立，受傷側肢體肩關節、肘關節的關節活動度 (Range of Motion, ROM)接近達到正常範圍，腕關節ROM亦恢復部份ROM的範圍，而殘指大拇指亦從無動作進步到出現部份的活動範圍。而在上肢功能評估問卷結果亦顯示個案上肢功能已逐步有增進。鼠蹊部皮瓣移植已經廣泛的用在手及前臂大範圍皮膚缺損的重建手術上，隨著手術技術的成熟，復健治療重心應放在如何預防因長期制動所引發的關節僵硬，及次發性冰凍肩的問題。早期手部職能治療的介入，盡可能在術後給予手部關節活動度運動、殘指肌力訓練及教導單手操作之技巧，不但可降低個案殘障受限的程度，更可提升個案上肢功能的表現。

Surgery often requires reconstruction of hand with a wide range of skin defects and loss of tissue due to machine crushing injury using pedicled groin flap. However, after receiving pedicled groin flap, the patient’s affected hand was attached to the groin and caused lengthy immobilization, thereby increasing the complexity of the rehabilitation process. In such cases, if early intervention of occupational therapy was implemented, it could avoid prolonged immobilization related complications. In this case report, in order to demonstrate the early intervention of occupational therapy for improving hand function, a case of successful pedicled groin flap due to hand crushing injuries was presented. The results indicated that after a half year of treatment, the case was recovered in good condition. The case was completely independent regarding basic activities of daily living. The range of motion (ROM) of the shoulder and elbow in affected side achieved normal ranges. ROM of wrist restored partial range of motion. The residual thumb appeared from no motion to partial ROM. Furthermore, the disabilities of the arm, shoulder and hand (DASH) outcome questionnaire also showed an improvement of upper extremities performance. Pedicled groin flap has been widely used in reconstructive surgery of large skin defects in hand and forearm. As surgical technology have reached a maturity, rehabilitation should focus on how to prevent joint stiffness and secondary frozen shoulder because of long periods of immobilization. Early referral to an occupational therapist with ROM exercises, strength training of residual fingers, and learning the one-handed method can not only reduce the level of disability, but also improve upper extremity function in patients.