don't have to be a boxer to suffer a boxers fracture. However, it does
generally involve hitting the hand on something that is stronger than
commonly seen in boxers, it gets its name from the mechanism of injury.
Let me tell you all about it...
As the name suggests, this injury often comes from a punching
mechanism. Seen often in boxers, fracture of the metacarpals occurs
when the closed fist strikes an object. Force is transferred directly
to the metacarpals, and if sufficient enough, they break.
You don't have to be a boxer to have this injury. Hitting your hand on
anything solid can cause the metacarpals to break.
I have seen several
of these in my career, and none of them were in boxers. Most occured
from punching the wall, or the goal post. Not exactly sporting
activities, but we all know how athletes can get when they are
The Bones Involved
A boxers fracture
is a break in one or
more of the metacarpals of the hand. Most commonly it is the third or
fourth that are broken. So, counting from the thumb side over, it is
the ring finger and pinkie finger side of the hand.
isn't specific to just one of the metacarpals, but because these are
the smallest of the five, they are most commonly injured.
Notice the break in the fifth metacarpal in the
picture to the right. I have circled it in red.
more about hand anatomy
Pain, swelling, and deformity are the most common symptoms of a boxers
fracture. The hand itself will swell up, often several times its normal
size. Pain is located along the outside of the hand, towards the pinkie
finger side. The back of the hand may be tender to touch, and you will
probably not be able to grip or make a tight fist.
When you do close your hand into a fist, your 1st knuckles will not
line up correctly, with the injured bone dropping down due to the
fracture. The deformity is espeicially noticible when compared to the
X-rays are needed to diagnose the boxers fracture, and depending on how
the bones are positioned, they may need to be set, or re-aligned to
allow proper healing. Sometimes, again depending on the severity of the
fracture, surgery to align the bones may be required.
Once diagnosed, the hand is usually placed into a cast for 4-6 weeks to
allow the bones to heal. A short forearm cast is usually enough to
provide good immobilization.
After getting the cast off, you may have motion
loss at the wrist and fingers, and rehab may be needed to get this
Returning to Play
Most fractures heal well enough to go back to activity in 6 weeks. This
is true for most boxer fractures. The bone will continue to remodel
itself for several months up to a year, but will be strong enough for
activity by this time.
Boxers fractures occur when you strike a solid object with a closed
fist. It involves the metacarpal bones, usually the third and fourth.
If you think you may have broken your hand, see your physician for
diagnosis and treatment. Most injuries like this will heal in 4-6 weeks.
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