When treating finger, hand, and elbow trauma (hereinafter, surgically treated hand trauma) in self-employed farmers, it is also necessary to consider how the patient will be able to continue working in the family business. This study investigated return-to-work outcomes of self-employed farmers in the Tokachi area in Hokkaido, Japan after surgically treated hand trauma. A survey was conducted with 56 self-employed farmers (39 men and 17 women, median age 55 years). More than 80% of the farmers (n = 49) returned to their previous work, and most returned to work during the farming season while still experiencing functional impairment. Self-employed farmers with surgically treated hand trauma tend to return to work in time for the farming season regardless of the severity of functional impairment they are experiencing, and it is important for health care providers to recognize this fact and consider return-to-work support as part of the treatment plan in addition to treatment itself. Therefore, providers must understand the processes and details of tasks performed during each farming season and devise individualized measures to accommodate patients returning to work while still experiencing impairment. In cases where multiple treatments are required, such as two-stage functional reconstruction, it is also important that the treatment plan consider the farming season, for example, by having the patient temporarily return to work and then undergo surgery during the off season.