A unique break of the bones of the hand that form the 4th metacarpal and 5th metacarpal (the "knuckles" on the pinky and finger next to it) is commonly referred to as a Boxer’s Fracture. To understand this break, you must know the basic structure of the hand.
The five metacarpals in the hand share the same anatomical configuration, consisting of a base, a shaft, a neck and a head. This is why the Boxer's Fracture is also called a "Metacarpal Fracture" Each metacarpal functions in the same manner by connecting each finger to a bone in the wrist. A typical boxer’s fracture is a break at the neck (the most slender part of the metacarpal) of the bone and this usually occurs in the ring finger (called a 4th metacarpal fracture) or pinkie (5th metacarpal fracture), as those bones are the most fragile and easiest to break.
Why this fracture has been nicknamed the boxers or brawlers fracture is simple – these bones are broken most frequently when someone strikes an immovable object. While the break is likely to occur from a blow delivered from a closed fist, it can also be cause by an open hand strike to a solid, intractable object.
Boxer's Fracture Symptoms
Common symptoms of a boxers fracture include pain, stiffness, or tenderness located in the hand in the area of the metacarpals or the knuckles. Other symptoms include swelling of the hand near the affected bones, coupled with bruising or discoloration. You could also feel abnormal movement of the bones at the site of the break. You could also have a cut to the hand near the area of the fracture; this is a sign of a more advanced break and should be treated by medical personnel.
A physical examination by your physician should give you a rough idea of whether a break has occurred, though the standard procedure is to confirm this with a simple X-ray. Often, the doctor will have the patient attempt to make a closed fist allowing the doctor to see if the bones are misaligned.
Boxer's Fracture Treatment
Treatment for this injury is predominantly non-surgical, a Boxer's Fracture Splint
is usually applied to keep the area from just above to just below the fracture immobile. By minimizing the amount of movement, the bones can slowly realign themselves and heal properly. Common medications administered or prescribed are anti-inflammatory medicines along with simple pain relievers. Often, acetaminophen, or Tylenol, is prescribed for the discomfort while you are healing. Cold therapy
can also be used initially to reduce swelling and reduce pain.