In managing any fractures of the hand, the basic principles of fracture management are the same whether treatment is closed or open. They are 1. Accurate reduction and stabilization of the fracture 2. Elevation and edema control 3. Mobilization of the unaffected joints 4. Early range of motion of the injured digit or digits when healing processes permit. Special situations and injuries require amendments to the basic principles. Open fractures require early and thorough wound debridement. Early fixation and serial wound debridement to assure a proper environment for bone or skin grafting are essential in caring for these severe injuries (Figs. 13-15). Numerous fixation techniques ranging from simple plaster splints, K-wires, external fixators, and small plates and screws are available for fracture care. Fractures of the hand are very common injuries that demand early recognition and treatment. The majority of fractures can be treated with closed methods. Recognition of those injuries that require operative treatment and prompt attention to detail and surgical technique will prevent many of the complications associated with these frequently encountered problems.