Objective: To evaluate of the division in anatomy, major principles and techniques of operative treatment on the instant repair of the defect of parenchyma in pollex in emergency department. Method: Classified by the division in anatomy of the defect of parenchyma in their pollices, 79 patients were repaired instantly in emergency department. These operative treatments were done subsequently: 18 cases by medium - thickness skin graft, 27 cases by full - thickness skin graft, 5 cases by advance skin flap of the palmar pollex, 11 cases by radiodorsal pedicle rotation skin flap of the forefinger and second metacarpus, 5 cases by reconstructed the extensor pollicis longus tendon with the extensor indicis tendon of forefinger and radiodorsal pedicle rotation skin flap of the second metacarpus, 13 cases by repair of the bed in fingernails after reduction and internal fixation of distal phalanges. Results: At the division of I b, II, I fm and II fm, all the skin grafts or skin flaps are survived. The division of I a (3 cases in this paper) were repaired secondly by island skin flaps with the dorsal neurovascular pedicle of forefinger. Conclusions: Instant repair of the defect of parenchyma in pollex in emergency department have these effectiveness, such as the instant repair, reservations function of pollex in maximum, reduced Costs and times in patients, expanding and improving the level of medical practice and clinical skills in Emergency Medicine.