Abstract: Objective To introduce the clinical application of the improved interosseous dorsal antidromic artery issular flap in the emergency treatment of the soft tissue defects in hand trauma. Methods 16 patients were received the interosseous dorsal antidromic artery flap for soft tissue defects in the hand with emergency treatment. Results All 14 flaps survived, tip necrosis occurred in 2 cases which healed without complications. Conclusion It was simple technical and shorten time in hospital with improvement of the emergency operative procedure of interosseous dorsal antidromic artery flap, and could reduce the impact of frequency of anatomic variations and vascular complications.