〔Abstract〕 Objective To analyze the therapeutic effect of traditional Chinese medicine(TCM) syndrome differentiation combined with controlled skin extension in the treatment of traumatic skin defects of extremities. Methods 70 patients with traumatic skin defects of limbs admitted to Luoyang Orthopaedic-Traumatological Hospital from July 30, 2014 to July 30, 2018 were selected and randomly divided into an observation group and a control group, 35 cases in each group. Patients in the observation group were treated with TCM syndrome differentiation combined with controlled skin extension, while patients in the control group were only treated with controlled skin extension, the therapeutic effect was evaluated. Results The total effective rate of the observation group was 94.29 %, which was higher than 77.14 % of the control group, and the difference was statistically significant (P < 0.05). The treatment satisfaction of patients in the observation group was 97.14%, higher than 80.00% in the control group, and the difference was statistically significant (P < 0.05). The wound healing time, hospital stay, dressing change times and antibacterial drug use time of the observation group were shorter than those of the control group, and the differences were statistically significant (P < 0.05). Conclusion In the treatment of traumatic skin defects of extremities, TCM syndrome differentiation combined with controlled skin extension has a significant effect, which can effectively improve the treatment satisfaction, promote wound healing, and shorten the application time of antibiotics and hospital stay.