Metacarpal and phalangeal fractures are common skeletal injuries, accounting for 10% of all fractures. Approximately one-quarter of these injuries occur during athletic events. Although an acceptable and stable reduction remains a key principle in this patient group, early mobilization and return to play may be higher priorities than in other patient populations. Orthopedic implant designs and techniques are evolving to facilitate operative fracture stabilization, improve union rates, and accelerate the postoperative course with early range of motion and return to play. This article discusses common patterns of metacarpal and phalangeal fractures resulting from athletic injuries, and current treatment strategies.