Proximal and the middle phalangeal fractures can be complicated because of small size of the bone and inadequate soft tissue support. In the treatment plan, a balance between the stability, alignment and motion should be maintained. The main goal is achieving the fingers pre-injury range of motion as soon as possible. This can only be maintained by a stable fixation of the fracture and early finger motion. Many treatment options are available such as buddy taping, splint immobilization, open/ closed reduction with K-wire, plate and screw or external fixation. The surgeon should have adequate knowledge of all available options; since, all these methods may be used separately or in combination to achieve the goal of treatment.