The treatment of post-burn palsy contracture deformity in children’s hands is very common, which not only affects the aesthetics, but also causes psychological barriers to children, and more importantly, affects the development and forms secondary deformities, which further affects the function of the hand and even causes irreparable loss of function. Therefore, the correction and rehabilitation of hand deformities after burns in children should be given great attention. The burn and skin repair surgery department of Hainan Provincial People’s Hospital Liang Zunhong 1. Characteristics of children’s hand post-burn palsy: (1) Because the skin keratinization layer of children is still underdeveloped and the skin structure is thinner, the same degree of burn damage to children often shows heavier than adults, so children’s hand post-burn palsy contracture deformity is more and more serious than adults. After the formation of deep burn scars, it not only destroys the appearance and function, but also causes abnormal growth of bones and joints; (2)) L children are in the growth and development period, because the elasticity and ductility of the hand scars area is very poor, it cannot be extended with the growth of bones and joints, and even restricts the activities of bones and joints, the thicker the scars, the stronger the pull on the bones and joints, thus making the range of motion of bones and joints smaller and the deformity aggravated. 2. surgery and timing: (1) purpose: is to restore the function of the hand as soon as possible, for severe deformity, at least to restore the hand pinch function; and children’s hands for the exposed parts, in order to reduce the aesthetic factors affecting their physical and mental development, to ensure the function of the premise to try to take into account the aesthetic; ( 2) timing: ① children’s poor self-control, often not easy to cooperate, can not be active functional exercise, hand palsy scar deformity more serious, the general conservative treatment effect is not good, the timing of surgical treatment to choose before it is too early, in the case of functional impairment can be selected in the 6 months after the injury surgery, can minimize the deformity of the hand; ② hand palsy scar contracture serious deformity more than 1 year, the hand nerve, blood vessels are bowstring shortening If the finger joints are reluctantly repositioned and straightened to normal, the vascular nerve bundle will be strained and narrowed, and the blood supply to the finger end will be insufficient, which will cause partial necrosis of the finger in serious cases. 3. In general, the paralytic scar excision or incision, release contracture, medium-thickness or full-thickness skin graft is the main. Skin graft repair should be used as much as possible, which can reduce the number of operations and avoid the disadvantages such as bloated appearance caused by the use of skin flap repair. Patients with severe secondary contractures should be treated with muscle lengthening, capsulotomy, joint surface adhesion separation, and interphalangeal joint fusion. For patients with exposed muscle keys or joint capsule who are not suitable for free skin grafting, tipped or free skin flap transplantation can be considered. For a few children with claw-shaped hands, it is advisable to make an extension of the finger on the back of the hand to lengthen the muscle cavity, cut the joint capsule on the dorsal side of the metacarpophalangeal joint, cover it with nearby soft tissue transfer, and then implant a free skin flap, generally the metacarpophalangeal joint can restore satisfactory flexion function. In some cases, the nerves and blood vessels are also shortened in a bowstring shape, so one operation often cannot achieve satisfactory results, and several operations are needed to correct the problem. For some children whose interphalangeal joints are already straight and difficult to recover, arthroplasty should be considered, so that the interphalangeal joints are fused in a functional position and fixed with Kirschner pins for 8 weeks, which can partially restore the function of the fingers. 4. Rehabilitation: The degree of recovery of hand function not only depends on the injury and surgical repair, but also is closely related to the early rehabilitation, especially the exercise of joint mobility. The functional exercise of hand joints should be started as early as possible after surgery. Since children are often difficult to cooperate, active exercise with the help of parents is the mainstay, and active exercise is better than passive exercise. In addition, physiotherapy, warm water bath and other rehabilitation treatments can reduce edema, prevent skin contracture, soften paralysis marks, improve local blood and lymphatic circulation, prevent muscle bond adhesions and joint stiffness, and significantly improve the flexibility, responsiveness and coordination of joint function. In conclusion, surgical treatment together with effective rehabilitation therapy can greatly improve the recovery of hand function in children.