The shoulder joint is the most mobile joint in the body, and scar contracture will seriously affect the voluntary movement of the shoulder joint. If the scar in the axilla extends to the trunk, the patient’s dressing, eating and posture will be affected; if the scar extends to the arm, the movement of the elbow joint will also be involved. The unique morphological structure of the axilla causes this area to be susceptible to scar contracture after a burn injury. In addition to insisting on exercising and wearing molds in the early post-burn period to preserve the upper limb’s abduction and shoulder joint’s range of motion as much as possible, plastic surgery is required in the later stage. 1.Selecting the timing of surgery: According to the patient’s age and the degree of scar contracture deformity, different surgery times are selected. The timing of surgery for children: for children with mild deformity, surgery is performed about one year after the injury; for patients with moderate deformity, surgery is performed after six months; for children with severe deformity, surgery is performed as soon as possible after the trauma heals. Timing of surgery for adults: Patients with mild or moderate deformities are operated on about six months to one year after the injury. Patients with severe deformities should be operated on within 3 months. Surgery at 1 year after the injury, the scar is basically stable and enters the mature stage of basal loosening, the anatomical level is clear, and the surgery bleeds less, which is especially suitable for those with mild scar contracture deformity, because scar contracture traction in children patients is easy to be followed by slow development of nerve, blood vessel and muscle, which leads to the upper limb not reaching the maximum degree of abduction after incision, thus affecting its development and increasing the difficulty of scar contracture release. 2, the choice of surgical methods: according to the degree of scar contracture deformity to choose different repair methods. (1) Scar relaxation and local reshaping: it is suitable for patients with mild deformity and Pu-shaped scars, this method is simple, the flap is not easy to necrosis, and the functional recovery is good after surgery. (2) Scar excision, loosening, local flap transfer repair: for moderate to severe scar contracture deformity, due to the wide range of scars and many tissue defects after incision, flap transfer repair is preferred as long as the surrounding normal skin is sufficient. (3) Scar excision, relaxation, flap free grafting: for severe deformity with no or very little normal skin around. 3.Post-operative precautions After surgery, a brace mold should be worn and the upper arm should be kept in an abducted 90-degree position to prevent re-contracture of the axilla, and early functional exercise should be performed under the guidance of the doctor to restore the function of the upper limb.