To explore the effect of plastic repair for patients with burn scar contracture deformity in hand. Methods A total of 52 patients with burn scar contracture deformity in hand admitted to our hospital from August 2020 to August 2023 were randomly divided into reference group and observation group, with 26 patients in each group. The reference group was given routine surgical treatment, and the observation group was given plastic repair treatment. The clinical efficacy, quality of life and appearance satisfaction of the two groups were compared. Results The total effective rate of treatment in the observation group was 92.31%, which was higher than 69.23% in the reference group, and the difference was statistically significant (P <0.05). After treatment, the scores of quality of life in the observation group were higher than those in the reference group, the differences were statistically significant (P <0.05). The appearance satisfaction of the observation group was 88.46%, which was higher than 57.69% of the reference group, and the difference was statistically significant (P <0.05). Conclusion The application of plastic repair for patients with burn scar contracture deformity in hand is effective, which can effectively reduce the scar, restore the patient's hand function, improve the appearance satisfaction, and play a positive role in improving the quality of life of patients.