The plantations of Acacia Malunion, refers to fracture healing in less optimal alignment. Clinically presented as twisting, bending, or shortening deformity, solitarily or in combination. That may happens in almost any fractured bone, when fractures untreated, improperly reduced, or inadequately immobilized. Exceptionally, the less protected hand long bones are more susceptible, because of the excessive deforming force tensions exerted on the smaller bony fragments, of the already small skeletal hand chain. Though its causes are known, the risk factors are a multi factorial dilemma including injury and patient factors, as well as our main concern, the iatrogenic risk factors. Here we are investigating retrospectively, the possible iatrogenic risk factors resulting in such defected healing process, In 68 malunited hand fractures, in 59 hands of 58 patients with significant skeletal deformities. following primary management of their original fractures by the emergency orthopaedic teams, at Aljala Teaching Trauma Hospital, Benghazi, between 2013 and 2017.