Purpose We describe the clinical management of a 37-year-old male who sustained a severe volar thumb defect due to a chainsaw injury. The injury involved a 4 x 3 cm skin defect and nerve deficits of the ulnar digital nerve (UDN) and radial digital nerve (RDN), as well as laceration of the flexor pollicis longus (FPL) tendon. The patient's functional and sensory deficits necessitated a comprehensive surgical approach. Methodology The patient underwent a complex reconstructive procedure involving multiple components. A reverse flow radial forearm flap was employed to address the skin defect, ensuring adequate coverage and wound healing. For nerve restoration, both UDN and RDN were grafted using the left medial cutaneous nerve of the forearm, aiming to re-establish sensory function. Additionally, repair of the left FPL tendon was performed to restore thumb flexion. Results Postoperatively, meticulous rehabilitation and wound care were crucial for achieving optimal outcomes. The patient's recovery demonstrated gradual improvement in sensory perception, thumb mobility, and overall hand function. Conclusion This case emphasizes the significance of a multidisciplinary approach in managing complex hand injuries, combining microsurgical techniques, nerve grafting, and tendon repair to restore both sensory and motor functions effectively.