Parents are very anxious when their children have deformities of the hands and feet. When my daughter was born for the first time, I looked at her facial features, hands and feet. I did not look at whether her facial features were delicate or not, whether her hands and feet were long and beautiful, but whether her facial features were neat and tidy, whether her hands and feet were different or not. The deformities of hands and feet encountered in the clinic, according to the part, more hands and less feet, according to the age, more children, less adults, according to the cause of injury, one is congenital deformity, two is post-traumatic deformity; In addition, the deformity can be alone, but also may be a local manifestation of the systemic syndrome. The treatment of hand deformity is difficult. Many parents of children with hand deformities are very concerned about the duration of treatment, treatment outcome and treatment options. Among the various congenital malformations, the incidence of juxtaposition of fingers is the first and polydactyly is the second. Regarding the timing of treatment Many parents are concerned about when to treat. In fact, it is not possible to make a generalization, and the timing of choosing treatment differs for different malformations. As a general principle, we hope that the earliest time is 6 months, why should we choose this time point? First, the child will be physically stronger and can tolerate the surgery better; second, it is relatively easy to open the surgery for a larger child; third: the risk of anesthesia can also be easily controlled. However, this is not to say that you cannot operate before 6 months of age, such as some simple polydactyly. The most important thing I tell parents is: the timing of surgery depends on the impact of the deformity on the child’s development, such as simple compound thumb deformity and some middle finger, middle ring finger syndactyly, etc., can be relaxed to about 2 years old. However, in the case of thumb-index finger syndactyly, early intervention is required, probably at the age of 6 months. In addition, post-traumatic hand deformities are also common in children in the outpatient setting. The most common cause of injury is boiling water from a drinking fountain, followed by burns from other heat sources and flame burns. When it comes to this problem, parents should pay attention to the water fountain at home to be placed in the location where children can not reach, especially not to let children play with the hot water outlet of the water fountain. In addition, Jiangnan winter more wet and cold, many families like to use hot water bags, here to give parents a heads up, to children with hot water bags when the temperature should be controlled, especially in the application of sleep, be sure to pay attention to not scalded. Children’s skin is delicate, high sensitivity, we adults feel tolerable temperature for children may cause danger. In addition, after children fall asleep, the cerebral cortex is inhibited, the sensitivity of the skin is reduced, unknowingly may cause low-heat burns. Children are often rushed to the burn unit for treatment after injury, and most of the patients who come to our orthopedic unit are those whose wounds have already scarred and healed. For this kind of post-traumatic scar contracture secondary deformity, the traditional concept of our plastic surgery department is to consider scar plastic treatment 3-6 months after the injury, why choose this time period? Because the formation and softening of scars is usually completed 3-6 months after injury, when it is easy to distinguish mature scar tissue by opening, and at the same time, it can reduce the formation of new scars and facilitate the recovery of hand function. However, this cannot be generalized, if the scar tissue is in an important hand function area and the patient is old, the treatment can be intervened earlier, otherwise waiting until the scar matures after six months may result in more loss of hand function, there is a problem of balancing point in terms of waiting time and recovery outcome, the grasp of this point is more difficult and varies from person to person and from injury to injury. For foot deformities, mostly syndactyly and polydactyly, the function of the foot is different compared to that of the hand, which is to accomplish various complex and fine movements, making the treatment time and program more complicated. The foot is mainly for weight bearing and walking, which is relatively less demanding from the perspective of function. However, with the development of the economy and the improvement of the standard of living, there is an increasing trend of patients with foot orthopedics, and children with foot orthopedics are often motivated by aesthetic considerations and the need for healthy psychological growth. As for the choice of treatment time and program can refer to the hand, the principles of both are similar. However, it should be noted that the implants in the weight-bearing area of the foot are not resistant to friction and weight-bearing and are prone to breakage, which is different from the hand. About the effect of treatment Many parents ask what will be the final effect of treatment, which is not clear in one or two sentences. The final result depends not only on the treatment plan, but also on the type of deformity, such as whether it is congenital or traumatic, and whether it is congenital and depends on the presence of diseases of other organs in the body. In the case of congenital hand deformity, a simple radial polydactyly with skin connection, a simple middle ring finger or an incomplete syndactyly of the middle finger, etc., the postoperative recovery is better. However, for deformities involving various tissues such as bones and joints, the recovery may be poorer. For scar deformity in children, the treatment effect of scar contracture of the palm is often better than that of scar contracture of the back of the hand, because in flexion contracture, the joint capsule and ligaments can be easily pulled apart and the sliding range of the flexor tendons is larger, but the deformity of scar contracture of the back of the hand is the opposite, so treatment is relatively difficult. Choice of treatment plan The treatment plan is of course crucial for the treatment effect. At present, for congenital hand deformities, many already have a more uniform treatment plan, such as syndactyly, which is basically a reshaping incision, flap forming and skin implant. However, the specific details of the various methods are still a little different, depending on the specific situation. In addition, patients with postoperative polydactyly, especially radial polydactyly, i.e. compound thumb deformity, are seen in the clinic as many such patients who were operated on in local hospitals as children and are now adults, most of whom have secondary lateral deviation deformity and retain their thumbs similar to several other fingers, which appear thin and small, which is regrettable. In fact, for various congenital deformities in children, we advocate preserving various tissues as much as possible without affecting development and function, and after they have developed into adults and become definite, we can consider reconstructive repair with reference to the healthy fingers and remove the unwanted tissues. Just like cutting clothes, the fabric should be prepared as much as possible, what is not needed can be left out, but if there is no suitable fabric, it will not make good clothes. In addition, among the various congenital hand deformities, megalodactyly is a deformity with a low incidence, but one that is difficult to treat. Regardless of the treatment plan used, the family of the child is often dissatisfied with the end result. There is a large gap between the treated giant finger and the normal finger, both in terms of appearance and function. However, for many diseases, doctors are still not infallible and it requires mutual communication, understanding and cooperation between doctors and patients in order to achieve the greatest success.