The Boxer’s fracture is a broken bone of typically the fourth or fifth metacarpal (ring or pinky finger). The metacarpal bones of the hand connect the wrist to the fingers and make up the arch of the hand. When a Boxer’s fracture occurs, the fracture is just proximal to the above the interphalangeal joint (PIP). This injury is known as a boxer’s fracture, because it often occurs from hitting an object with a closed fist such as a boxer.
Causes:
• Punching another person or object, such as a wall, with a closed fist
• Falls
• Playing certain sports
• Squeezing or crushing of the hand
Signs & Symptoms:
• Swelling
• Tenderness
• Deformity
• Inability to move the finger
• Depressed knuckle
Initial Treatment: Initially, rest, ice, and elevation as well as NAIDS are given, followed by X-ray and an evaluation.
Non Surgical Treatment: reduction of fracture as indicated, followed by an application of a specific splint.
Surgical Treatment: Surgery is indicated when the fracture is not stable after the reduction. Surgical internal fixation is then recommended using a plate and screw method. High level athletes tend opt for the fixation route due to potential return to play sooner.
Complications: If the bone heals with too much of a bend, it may mess up the action of the tendons which straighten the other finger joints, and result in a permanent bend in the middle knuckle of the finger.
Jessica M. Thomas MS, ATC, CHC
References:
Prentice, W., Arnheim Principles of Athletic Training, Eleventh Ed. 2003.
http://www.sportsmd.com/wrist-hand-injuries/boxers-fracture/
http://www.mountsinai.org/patient-care/health-library/diseases-and-conditions/boxers-fracture
http://www.eatonhand.com/hw/hw005.htm
