The Northern Territory poses unique challenges with its remote geography and vulnerable demographics. Method: Retrospective review of all hand injures from Jan 2007- Dec 2017 is collected Classified into Indigenous vs non-Indigenous, types of injuries are noted and timing of presentation from initial injury to seeking treatment is noted Results: Delayed presentation is double that of non-Indigenous group, complicated by high abscondment, lack of treatment completion and later presentation with complication Conclusion: Disproportionately high rate of Indigenous involvement with reduced completion of treatment is noted. Fight bites common in Indigenous population while nailbed and fracture dislocations underepresented as type of injuries. This is unique challenge to the Northern Territory sociodemographic and neccessitates more education, awareness and resources in bridging the gap and cultural barriers