The treatment of electrical burn injuries in the hand is difficult and challenging because the burn widely and deeply damages not only the skin and subcutaneous tissue, but also tendon, muscle, ligaments, and bone. Compound defects of the skin and abductor pollicis brevis tendon caused by an electrical injury were reconstructed using a free dorsalis pedis flap including the extensor hallucis brevis tendon. This composite flap is also applicable for reconstruction of thumb abduction, although its usefulness has been reported for reconstruction of defects of the dorsal skin of the hand including the extensor tendons.