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Abstract: Hydrogen generation from the hydrolysis of aluminum lithium/sodium borohydride (referred to as AlLi/NaBH4) system activated by Co powder with different particle size and amount was evaluated in this paper. The designed aluminum–lithium–cobalt (referred to as Al–Li–Co/NaBH4) systems including Al-5 wt% Li-50 wt% nano Co, Al-7.5 wt% Li-25 wt% nano Co, Al-5 wt% Li-50 wt% micro Co, and Al-7.5 wt% Li-25 wt% micro Co had 100% hydrogen yield at 323 K. The hydrogen generation rates of these systems were regulated by Co species, Co amount, as well as consecutive runs of NaBH4 hydrolysis. The underlying activation mechanism, including the formation of Al0.94Co1.06 alloy and highly active and stable Co-based catalyst has been elaborated in this study. Experimental data present an inexpensive and highly efficient hydrogen source for portable fuel cell. [Copyright &y& Elsevier]

Abstract: Four kinds of Y2O3 stabilized ZrO2 (YSZ) thin films with different Y2O3 content have been prepared on BK7 substrates by electron-beam evaporation method. Structural properties and surface morphology of thin films were investigated by X-ray diffraction (XRD) spectra and scanning probe microscope. Laser induced damage threshold (LIDT) was determined. It was found that crystalline phase and microstructure of YSZ thin films was dependent on Y2O3 molar content. YSZ thin films changed from monoclinic phase to high temperature phase (tetragonal and cubic) with the increase of Y2O3 content. The LIDT of stabilized thin film is more than that of unstabilized thin films. The reason is that ZrO2 material undergoes phase transition during the course of e-beam evaporation resulting in more numbers of defects compared to that of YSZ thin films. These defects act as absorptive center and the original breakdown points. [Copyright &y& Elsevier]

Abstract: This study evaluated hydrogen generation through the hydrolysis of an Al/NaBH4/Co/NaAlO2 system. Hydrogen generation performance can be altered by changing the Al/NaBH4 mass ratios, Co amount and NaAlO2 concentration. The optimized composite can achieve a hydrogen yield of more than 90% within 30 min. Thus, a high hydrogen generation amount and a stable solution pH were achieved. The kinetic analysis results of the Al/NaBH4/Co/NaAlO2 system show that the hydrolysis kinetic is affected by composition design. An activation energy of 53.3 kJ/mol was obtained from 0.2 g Al/0.2 g NaBH4/0.06 g Co nanoparticles/4 mL 0.4 M NaAlO2 solution, which confirms the control exerted by the chemical step. The improved hydrogen generation performance is attributed to the interaction of Al/NaBH4 hydrolysis and the synergistic catalytic effect of Co nanoparticles and NaAlO2. Thus, the mechanism that unifies the behavior of Al/NaBH4 hydrolysis, which is activated by Co nanoparticles and NaAlO2, is presented. As a potential hydrogen source, the Al/NaBH4/Co/NaAlO2 system can be applied for portable fuel cells with high hydrogen generation density and low cost compared with a conventional NaBH4 alkaline solution. [Copyright &y& Elsevier]

Objective: Multiple schwannomas localized in a single body part not crossing the midline constitute a rare variant of neurofibromatosis, segmental schwannomatosis. We report our experience with 5 cases of segmental schwannomatosis of the upper extremity and review the related literature to improve our skills in diagnosis and differentiation., Methods: Five patients with segmental schwannomatosis received surgical treatment in our department from 2003 to 2012, of whom 4 were female and the other one male. The mean age was 38 years, ranging from 29 to 48 years. In retrospect, we discussed the clinical appearance, histologic characteristics, genetic data and surgical management., Results: A total of 351 patients with schwannomas were treated in the recent decade. There were 326 patients with solitary schwannoma, accounting for 92.88%, 25 with neurofibromatosis type 2 (NF-2), occupying 7.12% and 5 with segmental schwannomatosis representing 1.42% of the total. Schwannomas are limited in one upper extremity and randomly located at ulnar nerve, median nerve and radial nerve and their branches, with no obvious predisposition. Their family history was negative for cutaneous tumors or central nervous system disease. Neurological examinations did not reveal symptoms related to vestibular nerves or optic nerves, which excluded NF-2 preliminarily. The prior symptom of three cases was pain which could be irradiated to the nerve distribution area. No pain but slight numbness was found in two cases. MRI disclosed multiple masses along the course of the nerves. They were isointense to muscle on T1-weighed images and hyperintense to subcutaneous fat on T2-weighed images. All schwannomas were resected and histological sections exhibited a characteristic feature of schwannoma. Follow-up work of 4.5 years was done to 4 cases and no recurrence or impairment of nerves was found., Conclusion: Segmental schwannomatosis is characterized by multiple schwannomas localized in one limb (upper extremity in our cases) without vestibular nerve tumors, most frequently seen in females at the age of 30-60 years. Segmental schwannomatosis is rarely seen in the previous literature. We found around 20 cases in English articles and no cases in domestic articles. In consideration of the clinical appearances of these 5 cases and the genetic research in the related literature, we recommend that segmental schwannomatosis is a distinct form of neurofibromatosis which needs to be more studied. We should also pay more attention to differentiating this disease from other forms of neurofibromatosis.

Objective: To evaluate the effect to the fixation stability of central screw placement during scaphoid fracture surgery., Methods: We designed oblique osteotomies for 32 identical sawbone scaphoids and fixed each specimen with a cannulated screw. Sawbone scaphoids were divided into 4 groups, according to position of the osteotomy (distal waist portion or proximal waist portion) and the position of the screw (central or eccentric). We performed Computed Tomography scanning to one specimen, and then the central zone of the scaphoid was established from volume data by using the preoperative planning system software (VxWork 4.0). The position of the osteotomy plane, the entrance and exit points of the screw guide pin were designed on the software as well. We placed the specimens under the increasing load of a pneumatically driven plunger to compare the load to failure and the distance at failure between the central and eccentric screw groups., Results: In general, we found the statistical differences of the load to failure and the displacement of fracture between the groups (F=31.485,P=0.001; F=33.328,P=0.018). The average load to failure and fracture displacement was more statistically different in the central group [(80.82 ± 15.63) N, (2.3 ± 0.5) mm] for proximal waist fracture than in the eccentric group [(58.32 ± 17.18) N, (3.1 ± 0.5) mm]. As to the distal waist fracture, the average load to failure and fracture displacement was better in the central group [(76.83 ± 14.54) N, (2.2 ± 0.7) mm] than in the eccentric group [(70.38 ± 13.32) N, (2.5 ± 0.6) mm] without significant difference., Conclusion: In this biomechanical model of an unstable oblique scaphoid fracture, we find that higher stability of fixation has been achieved with a screw placed centrally in the scaphoid, compared with a screw peripherally placed.

Background: Schwannomatosis is a recently recognized peripheral nerve polyneoplasm with clinical characteristics and a genetic background that differ from those of neurofibromatosis 2 (NF2). The diagnostic and treatment criteria of this rare disorder are herein discussed., Methods: The data of 180 patients who underwent operations for benign schwannomas from 2003 to 2012 in our center were reviewed. Eight of them were classified as schwannomatosis according to the diagnostic criteria suggested by MacCollin. The demographic characteristics were documented and compared between the two groups of patients. The patients' clinical presentations, imaging characteristics, histological features, and treatment results were retrospectively investigated and summarized., Results: Of the 180 cases of benign schwannomas we reviewed this time, eight patients presented with schwannomatosis (4.44%). The mean age of the two groups was not significantly different (40.0 vs. 44.7 years, t = 0.88, P = 0.378). However, schwannnomatosis seems to more generally occur in females (75% vs. 48% were females, P = 0.162), although the difference was not statistically significant. The initial main symptom was pain. The neurological examination was otherwise normal. Magnetic resonance imaging (MRI) revealed multiple discrete, well-defined round, or oval lesions distributed along the course of the peripheral nerves in the extremities with low-to-intermediate signal intensity on T1-weighted images and high-signal intensity on T2-weighted images. Vestibular schwannomas were excluded in four patients by cranial MRI. The lesions in all patients were resected and were pathologically proven to be schwannomas. The average follow-up period was 26 months. Six individuals obtained a good result without symptoms or function loss., Conclusions: Schwannomatosis is characterized by the development of multiple schwannomas without evidence of the vestibular tumors that are diagnostic for NF2. It commonly occurs in middle-aged females. It has similar demographic features to solitary benign schwannoma. Surgical resection always results in a good outcome.

Background: Symbrachydactyly is defined as a combination of short fingers with syndactyly. There are few published reports estimating the incidence of symbrachydactyly. The aim of this study was to investigate the clinical features and the outcome of surgical treatment for congenital symbrachydactyly., Methods: One hundred and twenty webs of thirty-four patients of symbrachydactyly were involved in the study. The sex ratio was 21 males/13 females. The age ranged from 1 year to 8 years, average 2.6 years. Four cases had both hands involved and 30 patients had one hand involvement. Release of the syndactylous digits webs were completed by one surgical procedure in 14 cases and more than one surgical procedure in 20 cases; 3 to 6 months between the procedures. In the meantime, some of the associated hand deformities were treated., Results: Postoperative follow-up time was 10 to 18 months, average 12 months. All the fingers involved in this study were separated successfully. However, 6 fingers had scar tissue contracture and 8 had web scar adhesion. All complications needed further surgical treatment. Parents of 94.1% of the patients were satisfied with the overall function of the hand, and 76.5% were satisfied with the cosmetic appearance of hand., Conclusions: The combination of syndactyly and brachydactyly is the main clinical feature in symbrachydactyly. Separation of the digital webs can greatly improve the function of the hand. However, more work needs to be done to improve the cosmetic appearance of the hand.

Objective: To review the experience with clinical and imaging characteristics of giant cell tumor (GCT) of the hand as well as the surgical outcomes., Methods: Between 2000 and 2010,16 cases of GCT of the hand were admitted to our department. There were 10 male and 6 female patients with a mean age of 41.3 years (age range: 24 to 65 years) with Campanacci's grade I ( n = 0), Grade II (n=12), and Grade III (n=4). Eight cases occurred in metacarpal bone and 8 cases in phalanx. All patients had the symptoms of pain,swelling and restricted range of motion in the affected joint.The average time from the onset of the symptom to the first visit of the patients was 12 months( range: 5 to 15 months).Radiographic changes showed osteolytic lesions occupying at least half of the diaphyseal region in most of the cases. Four grade III patients underwent tumor resection and bone graft or serial amputation, while 12 Grade II patients extensive curettage and bone graft., Results: Twelve patients'clinical and radiographic diagnosis at admission was endochondroma, while postoperative histopathology reported all the lesions as GCT. Twelve patients were followed up for a mean of 58.8 months (range: 24 to 140 months). Immediate relief of pain was observed postoperatively in all patients. No complications, such as infection or joint stiffness, were observed in any patient. The average healing time of bone graft was 3.3 months (range: 3 to 5 months).Ten gradeII patients were followed up for at least 2 years and 3 of them had local recurrence 8 to 16 months after first resection. En bloc resection was then performed, and no second reccurence was reported. Two gradeII patients were followed up for at least 2 years and none of them had local recurrence. No malignancy, multiple center lesion or lung metastasis was reported. Active range of motion in the patients without joint arthrodesis was maintained during the follow-up period., Conclusion: GCTs of the hand are relatively rare, and tend to be misdiagnosed as endochondroma. The results of the present study suggest that extensive curettage provides favorable local control and satisfactory functional outcomes.

Objective: To explore a reconstruction method for complete nail bed defect caused by various kinds of reasons and to retrospectively analyze the effect of application of free full-thickness skin graft for the whole nail unit repair., Methods: Between Apr. 2010 and Mar. 2012, the method of free full-thickness skin graft was done for reconstruction of the completely nail unit defect in seven cases. There were 2 male and 5 female patients; the mean age of these patients at the time of surgery was 51.9 years (range: 7 to 70 years). The preoperative diagnoses included two cases of malignant melanoma, one of chronic infection, one of squamous cell carcinoma, two of subungual pigmentation and one of junctional nevus. There were 2 thumb lesions, 3 middle and 2 index finger lesions. Nail unit defect was in the range of 1.5 cm×2 cm to 2.5 cm × 3.5 cm and full thickness skin graft was harvested from the same medial side of upper arm (3 cases), forearm cubital fossa (1 case) and contralateral side of groin region (3 cases)., Results: All the patients were followed with an average follow-up time being 10 months. All the free skin graft taken was achieved with 100% in all the 7 cases, even in those patients whose partial cortical bone had been curetted. The skin graft was often bluish initially, and superficial blisters were always noticed within 1.5 months postoperatively and the survival skin graft was smooth eventually, and skin graft was adhered to the underlying bone tightly. There was no epidermal inclusion cyst and no residual nail formation. The skin donor sites were without complications. Aesthetic appearance was assessed by the surgeons and found no unacceptable for their patients. And all the patients were satisfied with the cosmetic appearance and active range of motion of their involved fingers, who did not express a desire to undergo any further of nail reconstruction., Conclusion: Free full-thickness skin grafting for reconstruction of the complete nail unit defect is a simple, safe and effective procedure which provides a satisfactory aesthetic appearance and does not make any significant skin donor site morbidity especially for middle-aged and elder patients.

Objective: To establish an area by generating a surface model located a certain distance inside the scaphoid bone by computer analysis of three-dimensional reconstructions of computed tomography images, and define the central zone of the scaphoid., Methods: Twenty cases of three-dimensional computed tomography reconstructions of normal scaphoids in a computerized operation planning and simulation system (Vxwork software) were obtained. The scaphoid surface model was shrunk by using the function "erode" in the software until the waist portion became the one third size of the original waist portion of the scaphoid, and then another 1.5 mm shrinkage was made to get the central zone. Geometry and size of the central zone were evaluated and measured., Results: Geometry of all central zones was similar, as irregular as the scaphoid. The central zone could be divided into distal pole, waist portion and proximal pole. The narrowest part in the central zone was the waist portion, whose diameter ranged from 0.8-1.2 mm. Based on irregularity and size of the central zone, a screw axis could only be possibly contained completely either in the proximal, waist or distal central zone area, as it was very difficult to place the screw centrally in the whole scaphoid., Conclusion: The establishment of the central zone of the scaphoid three-dimensional computed tomography images could provide a baseline for discussion of central placement for scaphoid screw.

Objective: To study composition, distribution and causes of acute occupational hand injuries in Beijing Jishuitan Hospital., Methods: From April 1st 2005 to September 30th 2005, all patients with acute hand injuries were investigated by questionnaire focusing on all related epidemiological elements., Results: Two thousand six hundred fifty eight cases with acute hand injuries were about 17.3 % of patients with acute orthopedic injuries. Their mean age was (30.4 +/- 10.8) years old. The radio of males to females in cases with acute hand injuries was 57:1. The cutting and crushing injuries were the main causes of acute hand injuries. Most of cases with acute hand injuries were engaged in work related to machines. The acute hand injuries were mainly involved in index and middle figures of both hands, 94.9 % of acute hand injuries were opening, and 87.6% of acute hand injuries were involved in the deep tissues., Conclusion: Acute hand injuries are the common occupational severe injuries for young male workers. The acute hand injuries occur in patients engaged in work related to machines. The prevention of acute hand injuries should be emphasized.

Objectives: To establish a clinical method for measuring the displacement of the distal radioulnar joint (DRUJ) precisely irrespective of ulnar variance, and to derive normal population translation references with palmar and dorsal stress., Methods: Thirty-seven normal distal forearms were scanned with computed tomography using an apparatus designed by Pirela-Cruz. Each extremity was scanned in two positions: maximal ulnar palmar and dorsal stress. The digital imaging and communications in medicine (DICOM) CT images were then imported into Mimics 10.0 for three-dimensional reconstruction. On the DRUJs 3D images, choose the most prominent point of the palmar and dorsal margins of the sigmoid notch and the excavate ulna fovea as the reference points A, B and C. A perpendicular line was then drawn from the point C to a line connecting points A and B with the intersection D. Calculate the ratio of AD/AB and DB/AB. Two observers measured all the DRUJs independently and one repeated the measurements one month later to determine the interobserver and intraobserver reliability., Results: The mean ratio values of palmar (AD/AB) and dorsal (DB/AB) translation were 0.39 ± 0.07 and 0.37 ± 0.07, and the normal references (x(-) ± 2 s) were from 0.25 to 0.50 and from 0.23 to 0.50, respectively. No significant differences were observed in terms of positions, genders and dominant hands. The intraclass correlation coefficient (ICC) values for interobserver and intraobserver reliability (DB/AB, AD/AB) were 0.84, 0.80, 0.93 and 0.92, respectively., Conclusions: This new method could accurately measure the displacement of DRUJs with acceptable reliability, even with ulna positive or negative variance. Instability of DRUJ may be indicated when AD/AB is less than 0.25 or BD/AB is less than 0.23.

Objective: To study the biomechanical characteristics of antegrade intramedullary fixation for metacarpal fractures., Methods: From March to May 2008, both the 4th and 5th metacarpals from 25 formalin embalmed cadaver hands had three-point bending test after transverse osteotomy followed by randomly fixation with one of the following three methods: plate and screw, antegrade intramedullary K-wire, crossed K-wire. While, both the 2nd and 3rd metacarpals had torsional loading test after the same management as the 4th and 5th metacarpal had undergone., Results: In the three-point bending test, both the maximum bending moment (M(max)) and bending rigidity (EI) of the antegrade intramedullary K-wire were comparable with those of the plate and screw, and were significantly larger than those of the crossed K-wire. In the torsional loading test, the antegrade intramedullary K-wire had a statistically smaller maximum torque (T(max)) than the plate and screw, and had a comparable T(max) with the crossed K-wire; while, the torsional rigidity (GJ) of the intramedullary K-wire was statistically weaker than that of both the plate and screw and the crossed wire., Conclusions: One single antegrade intramedullary K-wire can provide a satisfactory M(max) and EI for metacarpal fixation and shows relatively weak in the torsional loading test. The injured finger should be well protected to avoid torsional deformity in clinical practice.

Objectives: To retrospectively study on malignant giant cell tumor of tendon sheath (MGCTTS) in the hand, and to evaluate its clinical, histologic, immunohistochemical features and biologic evolution., Methods: Between January 1991 and December 2001, 10 patients with histologically proven MGCTTS were treated. The clinical material, radiographs and hematoxylin and eosin-stained sections were reviewed. Immunohistochemical studies and nuclear suspensions for flow cytometry were done on paraffin embedded tissue. All patients were followed up., Results: Three of 10 patients in which the diagnosis of MGCTTS was originally considered were excluded after the slides reviewed and immunohistochemical examination performed. In the other 7 patients, one showed malignant and aggressive nature: the lesion recurred several times and the patient eventually died with pulmonary metastases. The immunohistochemical profile of the patient was similar to that reported in benign GCTTS, and the flow cytometry DNA analysis detected aneuploidy. Six cases presented histologic features of malignancy, 4 of them undertook the immunohistochemical examination and their profiles were similar to that reported in benign GCTTS. An aneuploidy DNA pattern was detected in one case on flow cytometry evaluation, diploidy DNA pattern was detected in 3 cases, and their S-phase fraction was 4.5%, 11.6% and 2.6% respectively. All of them had a benign clinical features, they were alive and without evidence of disease from 1.5 to 7.5 years (averagely, 4.5 years) after complete surgical excision or resections with wide surgical margins. None of them had received chemotherapy or radiation therapy., Conclusions: Malignant giant cell tumor of tendon sheath is an extremely rare malignant tumor, some cases have a poor outcome, the others, despite the histologically malignant features, have a good prognosis if wide surgical excision ablates the tumor completely.

Objective: To evaluate clinic pharmacodynamics of ropivacaine hydrochloride, a new long-acting amide type local anaesthetic, in Chinese patients undergoing neurolysis and tendolysis of forearm through axillary brachial plexus block., Methods: Two hundred ASAI-II persons, aged 18-65,weighing 60-75 kg, undergoing neurolysis and tendolysis of forearm under axillary brachial plexus block were randomly assigned to 4 equal groups to received ropivacaine of the doses of 1.00 mg/kg (Group I), 1.25 mg/kg (Group II), 1.50 mg/kg (Group III), and 2.00 mg/kg (Group IV). Each group was subdivided into 5 equal subgroups according to the concentrations (0.15%, 0.20%, 0.25%, 0.30%, and 0.35%). The effects were analyzed. Results There was no significant difference in starting time, consummating time, and persisting time of sensory and motor nerve block between Group I and Group II (all P > 0.05). The starting time and consummating time of Group III and Group IV were all significantly shorter than those of Group I (all P < 0.05), and the persisting times of Groups III and IV were all significantly longer than those of Group I (P < 0.05). 90 minutes after brachial plexus block the degrees of muscle strength Groups I and II were M1 and M2 respectively, hence, the sensory and motor nerves block was in dissociation. When motor never block was above M3 and M4 the interval of brachial plexus block was 55 min and 27 min in Group III and Group IV respectively., Conclusion: Sensory and motor never can be blocked perfectly when the dose of ropivacaine is between 1.5 mg/kg and 2.0 mg/kg and the concentration is between 0.30%-0.35%. When the doses of ropivacaine is 1.25 mg/kg and the concentration is 0.20%-0.25% the starting and consummating time are longer and persisting time is shorter. When the doses of ropivacaine is 1.00 mg/kg and the concentration is 0.15%-0.20% the starting and consummating time are longer and only satisfies external debridement and suture without tourniquets.

Objective: To analyze the clinical characteristics of 73 cases of macrodactyly., Methods: Review the incidence, distribution, characteristic, X-rays, pathogenesis and treatment of involved digits on the base of the clinical documents of 73 macrodactyly which were treated from 1965 to 2006. Twenty-eight cases had been followed-up., Results: Unilateral involved 71 cases, bilateral involved 2 cases. In upper deformities, the most involved digit was the index finger, followed by thumb and middle finger enlargement. In lower deformities, the second toes were affected more. There were 12 cases of static macrodactyly, which were all presented at or soon after birth. Sixty-one cases were progressive macrodactyly: 39 cases presented at birth; 17 cases occurred at about 2 years old; 5 cases were found after age 2. Thirty-seven cases of progressive type presented digital deviation; 3 cases associated with syndactyly; 16 cases complicated with thenar eminence hypertrophy; 8 cases of multiple-digit involved combined with palm and forearm hyperplasia., Conclusions: Macrodactyly in hand has a preference for the median nerve territory, mainly involving index, thumb and middle finger. Pedal macrodactyly prefers medial plantar nerve territory, the second toe is the most commonly affected. The progressive macrodactyly is more common than static. It may present at birth and combine with syndactyly, digital deviation, thenar eminence hypertrophy, palm and forearm hyperplasia.

Objective: To summarize the clinical characteristic and outcome of digital gigantism of the foot., Methods: Retrospectively analyze the clinical documents of cases of digital gigantism of the foot. Twelve 12 cases with 13 feet in this study included 8 male and 4 female with an average 4.6-years-old. All the deformities were found at birth. Multiple toes involved were more than single toe, and tibial toe involved more than fibular. Forefoot was enlarged. All the phalanges involved and partial metatarsal bones were enlarged. Marked increase in subcutaneous fat was found in all cases in the operation which infiltrated interossei and articular capsules. The appearance of the nerves and its branches in the foot were normal and fat infiltrating was not discovered. The operation types included debulking, epiphyseal arrest, amputation, nerve stripping and anastomosis., Results: Seven cases were followed up with mean periods 25.6 months. Functional evaluation according to a criterion formulated by author revealed a result of 2 excellent, 2 good and 3 fair., Conclusions: Digital gigantism of the foot is an uncommon congenital deformity of the foot characterized by overgrowth of both the soft-tissue and the osseous elements of the enlarged toe and forefoot. Surgical treatment is the unique method, and the goal is to reduce the size of the foot to allow fitting regular shoes and walking readily. There are several types of operations which to be chosen. The indication, the timing of operative intervention and the selection of operation type should be paid more attention.

Objective: To introduce the clinical features of a rare malignant soft tissue tumor., Methods: Review the clinical findings, pathologic features and results of the treatment of 16 cases of the epithelioid sarcoma in extremities, which were treated in our hospital from 1992 to 2004. Analyze the follow-up results of 14 cases., Results: The tumors occurred chiefly in young adults (mean age 30 years) and commonly involved soft tissue of the hand. Follow-up (average 25 months, from 1 to 112 months) information on 14 patients revealed relentless clinical course with frequent recurrence (71%). There was a significant difference between those patients in whom had a marginal and radical resection, both in recurrence rate and disease-free survival rate., Conclusion: It is safe to choose the radical resection of this disease after the tumor reoccurs.

Objective: To introduce a method for repairing and restoring hand function of the patients suffering from large surface area burn with scarce normal skin for reconstruction., Methods: Seven patients (ten hands) were treated in our department from April 1994 to February 2001. The TBSA involved with second- or third-degree burns was 85%-96%. All the hands had severe scar contracture on the dorsum and lost most of their function. A scarred skin flap, based on the ulnar border of the hand was elevated integrally on the dorsum. A random-pattern abdominal flap at a less-scarred area was designed and elevated to cover the defect of the hand while the scarred skin flap of the hand was transferred to the donor site of the abdominal flap., Results: All patients were followed for 0.5 to 4 years postoperatively. The range of motion of the metacarpophalangeal joint and the space capacity of the first web were greatly improved. All patients regained self-care ability., Conclusions: This method is simple and has satisfactory results. Under the circumstances where normal skin was not available for reconstruction, the function of the burned hand could be greatly improved by this method.