Highly comminuted phalangeal fractures with intra-articular extensions are common in developing 
countries. Traditional external fixation devices for such fractures are not readily available, are 
expensive and need considerable amount of expertise in its application. Patients and methods: A 
total of 20 patients with phalangeal fractures were managed by closed reduction and external fixation 
using simple syringe fixator and follow up was done at the orthopaedic department, Al-Azhar 
University hospitals over the period from February 2019 to December 2019. K wires and an empty 
syringe barrels were used. K wire was first passed through the barrel. Then the K wire with the barrel 
was inserted into the site proximal to the fracture just lateral to the central extensor slip. A second K 
wire was passed into the site distal to the fracture site while holding the finger in traction and 
reduction. The patients were recalled after 3 weeks. Results: The mean radiological union time was 
5.28 weeks. Mean period of treatment of phalangeal fracture is 10.02 weeks. The mean TAM was 
214.25 degrees. TAM was excellent in 12digits (60%), good in 4 digit (20%), fair in 2 digits (10%) 
and poor in one digit (5%). The functional results after fractures of the middle phalanx (mean TAM is 
214.4) had better recovery than those of the proximal phalanx (mean TAM is 213.6). Conclusion:
External fixation technique by simple syringe fixator is proved to be an efficient, simple and cheap 
alternative for hand fractures fixation showing superiority to other techniques.