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Fractures of the hand and fingers showing comminution or associated soft-tissue lesions are best treated with external fixation. In contrast to other systems, the new AO mini-external fixator enables less bulky unilateral fixation facilitating early mobilisation and the special design of the double clamps allows preliminary intraoperative stabilisation with only one wire in each fragment. Modular fixation makes free placement of the wires possible with accommodation of bone and soft tissue lesions. Twenty patients with hand injuries showed uneventful soft tissue healing and there were no cases of non-union in 19 metacarpal and phalangeal fractures.

Unlabelled: Between January 1st 1992 and December 31st 1993 140 non-complex (i.e. nerve, vascular, tendon injuries) fractures of the peripheral hand skeleton were operated at the Policlinic of the Kantonsspital Basel. In a retrospective study we analyzed results, complications and absence from work. We treated 110 male and 30 female patients with a mean age of 47 years. 45 fractures were treated by plate fixation, 45 by screw fixation, 53 times we applied k-wires and once a mini-fix-ex (AO-Prototype). Plate and screw fixation were performed with AO-mini-implants. 90% of our patients had an uneventful postoperative course. In spite of functional after-treatment we noted in 8.6% of the patients a relevant loss of movement leading to operative tenolysis in 7 patients. Fractures at the level of PIP were most frequently associated with loss of movement. Absence from work was 59 days in average (1-206)!, Conclusions: Peripheral osteosynthesis of the hand (non-complex) are effectively treated on an out-patient basis. In spite of functional after-treatment about 10% of patients have a relevant postoperative reduction in motility. Absence from work is relatively long after operative treatment of peripheral hand fractures.