T HE successfu1 repair of deformities of the hand is contingent on: (I) thorough study and evaIuation of the abnormaIity; (2) definite pIanning of each procedure; (3) the conservation of a11 avaiIabIe tissue; (4) prevention, if possibIe, of any Ioss of tissue; and (5) sufficient time intervaIs between surgica1 procedures. Many exceIIent papers have been written which dea1 with the congenita1 and acquired deformities of the hand. It is not my purpose in this brief resume to discuss these many probIems, but rather to discuss specificaIIy a few cases. One of these cases represents a congenita1 deformity, syndactyIism, which is rather common in children. Figure I shows biIateraI invoIvement of the fourth and fifth fingers. The other four cases iIIustrated and discussed are deformities of the hands fohowing deep burns with marked deformities. In a11 these cases strict adherence to the previousIy outhned principIes has been folIowed. Of special interest is the time interva1 between operations which I am sure in some instances has been perhaps a littIe longer than necessary; however, this time aIIowance, certainIy, aIIows for increased circuIation as we11 as more pronounced softening of the tissues and definiteIy has prevented tissue Iosses during the various procedures. A number of excellent methods are used in the repair of congenita1 syndactyIism invoIving the hands. It is my practice to operate upon these patients when they are approximateIy one and a half to two years of age. The method of repair is more or Iess dependent on the extent of the deformity as we11 as the operator’s preference in treating these cases. In most instances some skin grafting is necessary, but in others a very good resuIt may be obtained by muItipIe Z-pIasties. A good end resuIt, however, shouId be one that aIIows for compIete extension and hexion of the invoIved fingers with a deep and as norma a web between the fingers as possibIe. The repair of the simpIe skin web deformities is easily done. There are, however, instances when some joint changes may be produced in the fingers because of a bony union between the invoIved fingers which had not been cared for