Though early psychological symptoms after an acute traumatic hand injury have been described, there remains a need for knowledge concerning the trajectory of the individual’s response over time to the traumatic event. The purpose of this study was to describe psychological distress related to the traumatic experience in a cohort of patients with acute traumatic hand injury in a 10-year perspective. Patients were recruited consecutively at a hand surgery department. Data were collected by means of mailed questionnaires one week, three months, one year and 10 years after the accident. Eighty-three patients participated in all four measurements. Their experience of psychological distress related to the trauma differed significantly during the 10 years (p < 0.001). A quarter of the patients had symptoms indicating a risk of a psychiatric disorder one week after the accident. Most of them recovered naturally during the first three months but 10% had more persistent high level of symptoms during the first year after the accident. A few patients developed symptoms at risk level at three months and still had symptoms 10 years after the accident. At three months it appears possible to identify hand-injured patients with more persistent psychological symptoms and probably in need of a psychiatric consultation.