Objective To explore the effect of problem-oriented nursing intervention on psychological status and affected limb function recovery in patients after ffap repair surgery for extremity trauma. Methods A total of 60 patients who underwent ffap repair surgery for extremity trauma at the Third People's Hospital of Guizhou Province from May 2023 to May 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 30 patients in each group. The control group received conventional nursing intervention, and the observation group received problem-oriented nursing intervention. The ffap survival rate, affected limb function recovery, psychological status and nursing satisfaction were compared between the two groups. Results The ffap survival rate in the observation group (100.00%) was higher than that in the control group (86.67%) (P<0.05). The motor function scores of upper and lower limbs in the observation group at 4 weeks after intervention were higher than those in the control group (P<0.05). The scores of SDS and SAS in the observation group at 4 weeks after intervention were lower than those in the control group (P<0.05). The satisfaction in the observation group (100.00%) was higher than that in the control group (83.33%) (P<0.05). Conclusion The application of problem-oriented nursing intervention in postoperative care of patients after ffap repair surgery for extremity trauma can improve ffap survival rate and nursing satisfaction, optimize patients' psychological status, and effectively promote the recovery of affected limb function.