Background: Fractures of the hand represent a considerable burden upon the society in terms of medical costs and reduced workplace productivity. Aim of the work: The study aimed to evaluate the clinical outcome of patients with oblique and spiral phalangeal fracture managed with mini-screws fixation. Patients and Methods: A total of 20 patients presented with oblique and spiral phalangeal fractures were treated by mini-screw fixation and were followed for a minimum of 6 months. The mean age of the patients was 33 years, ranging from 19 to 46 years. Eleven cases were males and nine were females. Results: The functional results were graded as excellent in 14 patients (70%), good in two patients (10%), fair in two patient (10%), and poor in two patients (10%). The excellent and good results were considered as satisfactory, while the unsatisfactory included the fair and poor results. Thus, satisfactory results were found in 16 patients (80%), and the unsatisfactory ones were found in four patients only (20%). Conclusion: Mini screw fixation offers an effective, simple and reliable method for treatment of oblique and spiral fracture with low incidence of complication.