Boxer’s Fracture
A boxer’s fracture refers to a break in the neck of the fifth metacarpal bone, which is located just below the knuckle of the little finger. The hand is made up of three main types of bones: the carpal bones of the wrist, the metacarpals that form the palm, and the phalanges of the fingers. Five metacarpal bones connect the wrist bones to the fingers. Each metacarpal consists of four parts: the base, shaft, neck, and head. In some cases, the fractured bone may break through the skin, which is known as an open fracture.
Risk Factors
A boxer’s fracture most often occurs when a clenched fist strikes a hard surface, which is how the injury gets its name. Other factors include:
- Direct trauma to the hand
- Participation in contact sports
- Falling on an outstretched hand or arm
- Forceful twisting of the arm
- Medical conditions that weaken bone strength
Symptoms
Common symptoms of a boxer’s fracture may include:
- The little finger appears bent or misaligned
- Tingling sensations in the hands or fingers
- Numbness or a cold feeling around the little finger
- Swelling, pain, and bruising on the outer side of the hand
- Reduced range of motion in the hand
- Difficulty making a fist
What Happens if a Boxer’s Fracture Is Left Untreated?
If a boxer’s fracture is left untreated, it can lead to visible deformity of the finger and hand. Over time, this may result in reduced grip strength and difficulty using the hand effectively.
Diagnosis
Your doctor will begin by reviewing your symptoms and medical history. Then they will perform a physical examination of your hand to check for signs such as:
- Breaks or wounds in the skin
- A noticeable bump below the little finger
- A knuckle that appears deformed
- Changes in the shape of the outer side of the hand
Imaging tests, including X-rays, MRIs, or CT scans, may be ordered to confirm the diagnosis and assess the extent of the fracture.
Treatment
Treatment for a boxer’s fracture depends on how severe the break is. Your treatment plan may include a combination of the following approaches:
- Pain control with non-steroidal anti-inflammatory drugs (NSAIDs) and, in some cases, opioids.
- Avoiding activities that aggravate pain or strain the hand.
- Applying ice packs wrapped in a towel to reduce swelling and discomfort.
- Elevating the hand above heart level to minimize swelling.
- Receiving a tetanus shot if needed.
- Immobilizing the hand with a cast or splint for several weeks to promote healing.
- Participating in physical therapy to restore strength, flexibility, and range of motion.
- Considering surgery if conservative treatments are unsuccessful.
- Stabilizing the fractured bone during surgery using small pins.
- Following surgery, rest, the use of a hand splint, and physical therapy to improve hand function.
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