Severe post burn contractures of the hand cause hyperextension of the metacarpophalangeal joints and clawing of the interphalangeal joints with first web adduction contracture; this deformity makes the hand nonfunctional, more so if the contractures are bilateral.

Coverage by the free anterolateral thigh flap ensures intraoperative radical release; permitting better hand positioning that allows quick rehabilitation to get the hand to do the activities of daily living.

We present our experience of free anterolateral thigh flap coverage in 3 patients with bilateral post burn dorsal contractures of the hand over the past 8 years. Simultaneous reconstruction was done in one patient and sequential reconstruction was done in two patients.