Reconstructive Hand Surgery for Severe Post-Burn Scar Contractures
The dorsum of the hand contains paper-thin skin that allows tendons to glide effortlessly across finger joints. When deep burns heal with hypertrophic scarring, intense wound contracture pulls the metacarpophalangeal (MCP) joints into extreme hyperextension while curling the interphalangeal joints, creating a rigid 'claw hand' deformity. Simultaneously, scarring obliterates the interdigital web spaces and tethers the thumb flat against the palm, destroying pinch and grasp function.
Stepwise Surgical Restoration of Hand Anatomy
Dr. Vishal Purohit applies specialized hand surgery techniques to release contracted joints and restore motion:
- Joint and Capsule Release: Incising rigid dorsal scar tissue, releasing contracted dorsal MCP joint capsules, and dividing shortened collateral ligaments until fingers can fully flex into a closed fist.
- First Web Space Deepening: Freeing the adducted thumb using a five-flap web-plasty or local transposition flap, restoring thumb opposition and wide cylindrical grasp.
- Full-Thickness Skin Grafting: Resurfacing joint flexion creases with durable, thick skin grafts (FTSG) harvested from the groin or abdomen to prevent secondary scar contracture.
- Temporary Kirschner Wire Fixation: Placing fine smooth K-wires to stabilize finger joints in functional flexion for 2 to 3 weeks while skin grafts achieve 100% adherence.
Regaining Hand Function and Daily Independence
Structured occupational hand therapy, dynamic splinting, and silicone scar compression help patients write, eat, and handle daily objects with confidence.





