Introduction: Devascularized crush injury over the hand and digit frequently presents with soft tissue and vascular defects. A flow-through free venous flap can afford both healthy flap tissue and a well-protectedvenous conduit contained within. It therefore can solve the vascular and soft tissue defect s simultaneously with a single procedure.Case Presentation: CaseI: A 31-year old female suffered from circumferential crush over left distal forearm. The injury resulted in circumferential loss of all soft tissue in the trauma zone except the bare radial and ulnar bone. To salvage the devascularised hand, a venous flap with flow-through pedicle was harvested from left leg over lesser saphenous vein(5 by 8 cm). After all the tendons and nerves were repaired,the flap was applied to cover the defect with arterial blood flowing through flap's pedicle, first toperfuse the flap and then to revascularize the hand. Both the flap and hand turned pink and warm after operation.The flap and hand survived smoothly and basic hand function was regained at 1-year follow-up.CaseII: A 23-year old male suffered from avulsion injury over right index near PIP with loss of arterialinflow and volar soft tissue defect noted. A flow-through venous flap was harvested from right volar forearm for simultaneous repair of soft tissue defect and revascularization of the ischemic digit. Both the flap and digit survived satisfactory with acceptable functional return at 5-month follow-up.Conclusion: Combined soft tissue and arterial defects are the usual happenings in crush hand injuries requiring revascularization. Limited sourse of local flap due to tissue crush and the frequent morbidity associated withskin graft further increase the toughness of the situation. Flow-through arterialized free venous flap solvesthe problem by giving stable soft tissue coverage and bridging the arterial defect simultaneously. This appords the hand surgeons with a good and straight-forward approach to deal with the complex defect arterial stump .