This is a retrospective study of 38 patients with 44 unstable fractures of metacarpals and phalanges. 37 were males and one female had an average age of 32 years. The mean follow period was 16 months.

The operative procedure used to achieve stable fixation were Closed/Open K-wire fixation, mini-screws Mini-plates and screws. All patients with K-wire fixation were immobilized in a plaster splint for 3 weeks and those with screw or plate and screw fixation were immobilized in a bulky dressing and encouraged to make early gentle movements.

The overall results were good 64%, satisfactory 27% and poor 11.4%. It is observed that K-wire fixation is easy to perform with minimal soft tissue damage. A.O. screws and plates are reserved for special circumstances to be used only by surgeons experienced in A.O. techniques. Poor results are usually obtained in patients with extensive soft tissue injury, particularly with tendon injuries, flexor/extensor or both and more so in association with bone loss.