We present the case of a 33-year-old patient who sustained a detonator explosion injury to the left hand, initially resulting in amputation of the last two fingers (little and ring fingers) as well as a large, complex wound. Primary management consisted of surgical debridement and lavage, empiric antibiotic therapy, and local wound care. After guided healing, a 6 × 3 cm skin defect persisted. Reconstruction using a MacGregor flap was performed. The article details the steps of marking along the groin crease, flap elevation, transfer to the hand, pedicle immobilization, and the second-stage division procedure. The outcome was favorable, with good flap integration and satisfactory functional recovery. The discussion reviews the indications, technical variations, and alternatives to this flap.