Background: Dorsal hand injuries or defects in diabetic patients are usually complicate by skin loss, tendon exposure, then aggressive hand function loss. They are less common reports about this subject in literature. Objectives: This study was designed to providea clinical report and outcome observations about the use of RRFF in the reconstruction of dorsal hand defects associated with tendons exposure. Results: All flaps, were survived, but each case of the ten cases of the study had developed recipient and /or donor complications, but fortunately there is no complete flap loss or another major complication. Conclusion: Our observations are recommending the use RRFF as it is a reliable option in the reconstruction of the dorsal hand defects in diabetic patients, although it has higher incidence of flap and donor site complications.