A Review of Boxer's Fracture: Causes and Management Introduction Boxer's fractures make up 20% of hand fractures.
A Review of Boxer's Fracture: Causes and Management Boxer's fractures make up 20% of hand fractures. A boxer's fracture is a fracture of the fifth metacarpal neck. The fracture is typically the result of the compression force through the fifth metacarpal neck when the hand is in a fist position.
Fractures of the fifth metacarpal neck are actually less commonly seen in experienced boxers. More experienced boxers load the index finger when punching. Diagnosis The evaluation of the hand on physical exam first requires providers to inspect the hand for soft tissue swelling, pain, and for any open fracture.
Physical exam needs to evaluate for shortening, rotation, and angulation of the metacarpals. The fifth metacarpal is more likely to experience shortening due to less soft tissue support. A neurovascular exam also needs to be performed evaluating the phalange distal to the injury.
Diagnosis can typically be made with three standard views of the hand. There is debate as to what type of xray and measurement providers should use to determine the amount of fracture angulation. A study published in 2005 in the Journal of Orthopaedic Research evaluated plain radiographs to see which view had the most reliability and validity for measuring angulation.
They found that measuring angulation with the lateral view had the most validity. Figure two is a radiographs of a boxer's fracture A CT scan of the hand can be performed to evaluate severely comminuted fracture or intraarticular fractures. Treatment The goal of boxer's fracture treatment is to have recovery of preinjury function by restoring the alignment and stabilization of the bone.
If you are experiencing symptoms that may be related to boxer's fracture, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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