title: [Repair of claw hand deformity after burn].
abstract: OBJECTIVE
  To summarize methods for repair of claw hand deformity after burn.
  
  
  METHODS
  Ninety-seven patients with 136 claw hands after burn hospitalized from May 1992 to May 2007 were repaired with skin grafting (104 hands) and transposition of skin flap (32 hands), among which 21 hands were minor-grade, 92 hands moderate, 23 hands severe. The metacarpophalangeal joint was repaired after scar release in dorsum of hand with manual extraction reduction, release of collateral ligament and joint capsula, separation of adhesion in joint, tendon lengthening for obvious contracture. Restitution of finger flexion deformity, lysis of adhesion and grafting among first web and finger webs, repair of central slip extensor tendon or phalangeal arthrodesis were performed according to the abnormal condition after lysis of dorsal scar of hand. The metacarpophalangeal joint from 31 patients were not repaired with above methods for severe finger flexion deformity, their palmar scar were loosened and transplanted firstly, then scar in dorsum of hand were loosened, metacarpophalangeal joint were repaired, flap or skin were transferred or transplanted. General rehabilitation were performed routinely after operation.
  
  
  RESULTS
  The ending of flaps (4 hands) due to the scar were necrosis after transposition and healed through dressing change, other skins or flaps all survived. Most articular deformities were corrected completely or basically. Functions including palmar opposition, grasp were also recovered with satisfactory results.
  
  
  CONCLUSIONS
  Skin transplantation and transferring of skin flap with overall planning and individual isatin are the key points for repair of claw hand after burn.
authors.affiliation: Department of Burns and Plastic Surgery, Xiangya Hospital, Central South University, Changsha 410008, PR China.
authors.forename: Pi-hong
authors.initials: PH
authors.lastname: Zhang
authors.forename: Xiao-yuan
authors.initials: XY
authors.lastname: Huang
authors.forename: Peng-ju
authors.initials: PJ
authors.lastname: Fan
authors.forename: Li-cheng
authors.initials: LC
authors.lastname: Ren
authors.forename: Jian-hong
authors.initials: JH
authors.lastname: Long
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology / Q000601:surgery; D005260:Female; D006227:Hand Deformities, Acquired / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D016038:Skin Transplantation; D013524:Surgical Flaps; D055815:Young Adult