We retrospectively studied primary and reconstructive single ray resection at 16 to 150 months after surgery (median, 41 months) in 25 patients (18 males) whose average age was 28 years. Cases were reviewed 16 to 154 months after surgery (median, 41 months). The injuries involved 14 dominant and 11 nondominant hands. Twelve patients had primary ray resection (< or =2 weeks after injury) and 13 had secondary/reconstructive amputation of 18 border and 7 central digits. Examinations and functional testing by Minnesota rate of manipulation and timed grooved pegboard tests were done and x-rays were reviewed. The majority of patients were subjectively satisfied with the appearance and function of the hand. Patients lost an average of 13 weeks of work (range, 2-24 weeks); those with primary resection were out of work 9 weeks (range, 2-17 weeks) and patients who had secondary resection lost a total of 16 weeks of work (range, 7-24 weeks). Twenty-one of the 25 patients returned to their preinjury occupation. Evaluation of nonwork plus settled workers' compensation cases versus nonsettled compensation/litigation cases showed that there were statistically significant differences in grip strength, key pinch, oppositional pinch, and Minnesota rate of manipulation test results. Primary ray removal limits the total costs associated with injury and disability; unsettled compensation/litigation issues produce statistically disparate and otherwise physically inexplicable differences.