The hand is a common site of injury in children and adolescents. A thorough history and physical examination along with adequate radiographic imaging are essential. The most common mechanism of injury in younger children is crush injury resulting from the hand caught in a closing door while most fractures in teenagers result from recreational sports. Accurate diagnosis and timely management of these injuries continue to be the cornerstone of optimal hand functions. Metacarpal and phalangeal fractures can be difficult to diagnose at radiography due to their relatively small size, leading to potential delays in treatment. Early recognition and prompt diagnosis are necessary to achieve a satisfactory outcome. Recognition of common fracture locations and patterns is essential in ensuring prompt and appropriate treatment.