Metacarpal and phalangeal fractures are common athletic injuries that can significantly affect the athlete's career when they occur during the season and affect the athlete's training when they occur in the off season. This situation is particularly relevant if there are complications or if fixation is not stable enough to permit early range of motion and rehabilitation. This article discusses percutaneous and open reduction techniques of hand fractures as these injuries pertain to athletes. The goal is stable fixation to allow early return to competition and rehabilitation.