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Arthrodesis of selected small joints of the hand is often indicated; however, in previously reported series nonunion is not uncommon. There were 171 consecutive arthrodeses of small joints performed on 134 patients. The operative method employed was essentially the method described by Littler. Emphasis was placed on the accurate coaptation of bone surfaces, the use of cancellous bone graft when needed, maintenance of the coaptation with Kirschner wires, and the need for postoperative immobilization. This technique resulted in union of 170 out of 171 arthrodeses (a nonunion rate of 0.6%). There were no infections. There were four delayed unions.