Proximal phalangeal fracture is a common fracture affecting many patients during their work or participating in sports activities. It hasa devastating effect on economical and psychological aspects of patients whose occupation is dependent on their manual activities. Many of these patients are not willing to have their hand immobilized for such long time.This study aims to compare the results of proximal phalangeal fixation after percutaneous fixation using k-wires and ORIF.The purpose of this prospective study is to document the functional outcome of different types of phalangeal fixation and to evaluate the clinical results.Twenty nine patients was the sum of this study and were divided into three groups: Thumb group: three patients ; Percutaneous fixation (Group A): eleven patients ; ORIF (group B): fifteen patients.These patients were followed up for a minimum of 6 monthsPatients were 24 men and5 women within average age of 34 years. All patients were evaluated for clinical and radiographic results. Fracture union was achieved in 29 cases (100%) at a mean of 6.29 weeks (5 to 8 weeks). Return to work ranged from 6 weeks to 9 weeks according to their occupation .This study proves that percutaneous fixation of unstable proximal phalangeal fractures is a useful technique that do not demand open reduction. Soft tissue dissection and swelling is minimized. One limitation is that motion exercises are often delayed due to immobilization and sometimes cannot be started until the K-wires are removed. However, for many patients, percutaneous k-wires can minimize complications and provide excellent results in comparison to ORIF.