The social and economic factors of injury to, or amputation of, a distal phalanx in a series of 240 patients have been discussed and analyzed. It was demonstrated that judicious modification of the established rigid conditions for reparative hand surgery may be applied without compromising the results. The adoption of a scheme of ambulatory management simplified postoperative care and was eminently satisfactory in the early rehabilitation and return to work of a majority of the patients in the group which was studied. The ambulatory system of care also effected substantial savings in hospitalization costs. The surgical principles for reparative surgery in trauma of the hand were reiterated and methods for reconstructing finger tips, utilizing the remaining pulp and the nail, in various types of injury were demonstrated.