What Causes a Boxer's Fracture?

A boxer's fracture most commonly occurs when someone punches a hard surface or another person with a closed fist. Since most people punch in a direct roundhouse fashion, the greatest impact in a punch falls on the metacarpal bone of the little or ring fingers. The force concentrates at the metacarpal neck, leading to a fracture.

A boxer's fracture can also occur when a person tries to break a fall with a closed fist to the ground or by direct trauma to the hand. Ironically, this injury rarely affects experienced boxers. Professional boxers are trained to punch with even force over the entire hand, maximizing force and minimizing injury.

Boxer's Fracture Symptoms

The most common boxer's fracture symptoms include:

• Pain

• Tenderness

• Swelling around the knuckle of the affected finger

Bruising and deformation of the knuckle may also be present, and extending the finger may be difficult. The finger may be difficult to straighten or may cross over the other fingers.

How is a Boxer's Fracture Diagnosed?

​​Your Resurgens physician will ask you about your symptoms, the cause of the injury, and your medical history. They will also examine your hand carefully, checking for pain, strength, misalignment, range of motion, breaks in the skin, and other signs of injury.

X-rays may be taken to confirm the diagnosis of a boxer's fracture and provide images of the fracture and any foreign bodies embedded in the hand. These diagnostic scans are essential for helping your physician plan the ideal treatment plan.

Boxer's Fracture Treatment

Once your Resurgens physician has diagnosed you with a boxer's fracture and determined the extent of your injury, they will tailor a treatment plan to your unique injury.

Non-Surgical Treatment

The most common boxer fracture treatment involves using a cast or splint for 3-6 weeks. One type of splint may extend from the fingers, with the fingertips exposed, to the forearm near the elbow. Another system that is effective for some boxer's fractures of the little finger is to buddy-tape the ring finger and little finger together. Your doctor will decide what type of splint will create the best results for your fracture.

You also may need to work with a physical therapist for a while as your fracture heals. You'll learn exercises to strengthen your hand muscles and keep them from getting stiff.

Surgical Treatment

If non-surgical treatment is not effective, or if the fracture is severe, your doctor may recommend surgery. Surgery for a boxer's fracture typically involves open reduction and internal fixation. In this type of procedure, an incision is made in the skin overlying the fracture, and rods, pins, or screws are implanted in the bones to keep them in place. The wound is closed, and a splint is placed. Once the splint is removed, physical therapy is recommended to strengthen the surrounding muscles and restore function.

If you're struggling with boxer fracture symptoms, schedule an appointment with one of our Resurgens Hand & Wrist physicians now!