Boxer's fracture
| Boxer's fracture | |
|---|---|
| Other names | Metacarpal neck fracture of the little finger, scrapper's fracture, bar room fracture, street fighter's fracture |
| Boxer's fracture of the 5th metacarpal head from punching a wall | |
| Specialty | Emergency medicine, orthopedics |
| Symptoms | Pain, depressed knuckle |
| Causes | Hitting an object with a closed fist |
| Diagnostic method | Based on symptoms and confirmed by X-rays |
| Treatment | Buddy taping and a tensor bandage, reduction and splinting |
| Medication | Ibuprofen, paracetamol (acetaminophen) |
| Prognosis | Generally good |
| Frequency | 20% of hand fractures |
A boxer's fracture is the break of the fifth metacarpal bone of the hand near the knuckle. Occasionally, it is used to refer to fractures of the fourth metacarpal as well. Symptoms include pain and a depressed knuckle.
Classically, it occurs after a person hits an object with a closed fist. The knuckle is then bent towards the palm of the hand. Diagnosis is generally suspected based on symptoms and confirmed with X-rays.
For most fractures with less than 70 degrees of angulation, buddy taping and a tensor bandage resulted in similar outcomes to reduction with splinting. In those with more than 70 degrees of angulation or in which the broken finger is rotated, reduction and splinting may be recommended.
They represent about a fifth of hand fractures. They occur more commonly in males than females. Both short and long term outcomes are generally good. The knuckle, however, typically remains somewhat deformed.