Understanding a Boxer's Fracture of the Hand

A boxer’s fracture is a break in the fifth metacarpal bone, one of the bones between the finger bones and the bones of the wrist. The break is in the neck of the bone, just below the fifth or pinky finger. The fracture gets its name because it's a common injury for boxers. However, it can happen in various ways and also occurs among people who play other contact sports.

When boxers punch, they do so with a clenched fist. The positioning of the fist and the force of the punch are what cause the bone in the pinky to fracture or break.

It's possible to sustain a boxer's fracture from punching any hard surface or falling on a clenched fist. The neck of the fifth metacarpal bone is one of the weakest points in the hand, making this a common fracture site. It's also possible to sustain a Boxer's fracture playing contact sports if the hand collides with an object or person with force, such as physically blocking an opponent in football.

Athletes, particularly boxers, have a high risk of developing a boxer's fracture, but even those who play contact sports recreationally can experience this break. A previous injury to the bones in the hand or weak bones due to osteoporosis or an injury also increases the risk of sustaining this type of fracture.

The most common symptom of a boxer's fracture is pain or swelling at the base of the fifth finger. The finger may be hard to move and bent or misaligned. There could be crunching, popping, or snapping sounds during movement, and bruising and discoloration at the site of the fracture. If the nerves are involved, there may be numbness or tingling.

Physical examination to look at range-of-motion of the hand and fingers and for visible signs of bruising is the first step in diagnosing a boxer's fracture. A boxer's fracture is sometimes hard to spot on a standard x-ray, so the practitioner may order multiple images from different anglesto make the break easier to detect.

The treatment of a boxer's fracture is usually a cast or a splint to keep the hand immobile until the fracture can heal. Medications can reduce inflammation and relieve pain. Keep the hand elevated above the heart to reduce swelling. If the bone is out of alignment, surgery may be necessary for complete healing to occur. Some doctors refer their patient to an orthopedist, a specialist who deals with bone abnormalities, for a follow-up, to ensure the fracture heals properly.

The standard therapy for a Boxer's fracture is a cast or splint to support the hand and reduce movement. Home therapy may include applying ice to relieve swelling and ease the pain. Watch for signs of discoloration and bruising and report any symptoms that occur, especially numbness, tingling, or loss of feeling in the fingers.

If treated early, boxer's fractures have a good prognosis. Immobilization of the hand helps promote proper healing and lowers the risk of complications. Delaying treatment decreases the likelihood of the fracture healing properly and can lead to longer-term complications.

Complications may occur with a Boxer's fracture if the fracture goes untreated or if treatment is delayed. Inadequate or delayed treatment can cause the bone to heal in an abnormal manner that restricts full use of the hand.

If there's abnormal healing, the finger or hand may look mishappen and it may be hard to grasp and hold things. Prompt medical attention and treatment reduce the odds of this outcome.

The best way for boxers to avoid a boxer's fracture is to learn how to punch properly. If the fourth of fifth fingers make the initial contact or sustain the disproportionate force, the risk of fracture is higher. Wearing boxing gloves while training helps protect the hands. Also, maintaining healthy bones and avoiding bone loss lowers the risk of bone fractures in general.