What is a Boxer’s Fracture?
A boxer’s fracture is a break in the neck of the fifth metacarpal bone of the hand (under the little finger) near the knuckle.
The hand consists of 3 types of bones: the carpal or wrist bones, the metacarpal or long hand bones, and the phalanx or phalanges. The metacarpals are made up of five long bones that connect the carpal and phalanxes.
Structurally, the metacarpal bones can be divided into four parts: base, trunk, neck and head. In some cases, the broken bone can protrude through the skin and is called an open fracture.
Risk Factors
A boxer’s fracture is usually caused by being punched against a hard surface when your hand is clenched into a fist.
Other risk factors include:
- Trauma
- Close contact sports.
- Falling on an outstretched arm.
- Severe flexion of the arm.
- Medical conditions that weaken your bones.
Boxer’s Fracture Symptoms
Symptoms of include:
- The little finger looks bent and misaligned.
- Tingling sensation.
- The area around the little finger feels numb and cold.
- Pain, swelling and bruising on the outside of the hand (blue).
- Limited range of motion of the hand.
- Difficulty forming a fist.
What Happens If A Boxer’s Fracture Is Untreated?
An untreated boxer’s fracture can result in an abnormal-looking finger and hand. Gradually, you may experience a decrease in grasping ability.
Diagnosing a Boxer’s Fracture
- Your doctor will evaluate your symptoms and take a medical history.
- Physical examination of the hand will be done by looking for signs such as the following.
- Cracks in the skin
- A lump under the little finger
- Deformed visible joint
- Different shape on the outside of your hand
- Imaging studies such as X-ray, MRI or CT scan will be ordered to confirm the diagnosis.
Boxer’s Fracture Treatment
Treatment of a Boxer’s fracture depends on the severity of the fracture.
Your treatment plan may include:
- Taking a combination of non-steroidal anti-inflammatory drugs (NSAIDs) and opioids to manage pain
- Avoiding activities that trigger symptoms
- Applying ice packs on a towel to the area to reduce swelling and pain
- Raising your hand above heart level
- To have tetanus vaccination if necessary
- Cast or splinting to immobilize the hands for several weeks
- Physical therapy to regain strength and mobility
Surgery may be recommended if you do not respond to conservative treatment options. Stabilization of the broken bone will be achieved by using small needles. Surgery is followed by rest, use of hand splints, and physical therapy to increase flexibility, range of motion, and strength.