SUMMARYA series of 369 patients with compound injuries of 462 distal phalanges was presented. The surgical methods of repair for the various types of injury, utilizing remaining local tissue and split grafts, were detailed. The adoption of a scheme of ambulatory care with avoidance of hospitalization, general anesthesia, tourniquet and antibiotics simplified postoperative care and effected substantial savings in hospital costs. It was demonstrated that judicious modification of the accepted rigid conditions for reparative hand surgery could be made without compromising the results.The effectiveness of the plan of care and the technics of repair is indicated by the salvage of all phalanges not damaged irreparably by the original injury. Further indications of the effectiveness of the method presented were the relatively few office visits required, the average loss from work of only 18 working days, and return to work of 96.7 per cent of the patients treated within 8 weeks.