Background: Hand fractures represent a considerable burden upon society in terms of medical costs and reduced workplace productivity. Fractures of the metacarpals and phalanges are the most common fractures of the upper extremity. Outcome of conservative treatment in displaced, irreducible, unstable and rotational fractures is poor. Objective: To assess the outcome of fixation of oblique and spiral fractures of phalanges and metacarpals of the hand by interfragmentary mini screws and to evaluate the rate of complications. Patients and methods: A study included 18 patients with oblique and spiral fractures, 6 metacarpals and 12 phalangeal fractures. Patients were managed by open reduction and internal fixation using mini Interfragmentary screws with lag technique at Zagazig University Hospital and Zagazig General Hospital. Results: Four weeks postoperative, the mean total active motion (TAM) score was 83.22 ± 13.26. Early range of motion assessment revealed one (5.6%) poor, two (11.1%) fair, five (27.8%) good and ten (55.6%) excellent results. The end results by measuring grip strength of affected hand for metacarpals was excellent in two patients (40%), good in two patients (40%) and fair in one patients (20%). The mean grip strength for metacarpals was 85.8 ± 7.5. While the grip strength of affected hand for phalanges was excellent in eight patients (61.5%), good in four patients (30.7%) and fair in one patients (7.7%). The mean grip strength for phalanges was 90.07 ± 7.3. Conclusion: Inter-fragmentary mini lag screws fixation represents an effective method for managing such rotationally unstable fractures as oblique and spiral hand fractures. Younger patients with hand fractures revealed better results of range of motion and hand function.