Boxer fracture (fracture of metacarpal bone in hand)
A “boxer fracture” is a break in one of the metacarpal bones of the hand. Metacarpal bones form the knuckles and connect the finger bones to the wrist bone. Boxer fractures are breaks in the neck (top portion) of metacarpal bones and usually involve the ring and little fingers. These fractures generally heal very well with proper treatment.
How it occurs
Boxer fractures most commonly occur when punching a hard object with a closed fist. They can also occur when an open hand hits a hard object.
Signs and symptoms
Individuals with this type of fracture feel pain around the injured bone. There may also be swelling, discoloration, and/or bruising at the injury site.
Diagnosis
The doctor will carefully examine the hand at the injured area. An x-ray will show a fracture/break of the metacarpal bone.
Treatment
At the time of injury, applying ice and elevating the injured hand can help reduce swelling. Most boxer fractures require only a splint or cast to immobilize the hand and prevent further injury. Cast/splint treatment generally lasts 3-6 weeks. Occasionally, patients require surgery for severely displaced fractures. Your physician may obtain repeat x-rays during the treatment phase to make sure the fracture is healing properly. Total healing time is usually 6-8 weeks.
Returning to activities and sport
The goal is to return your child to sports as quickly and safely as possible. However, if he returns to play too early or plays with pain, he is at risk for further injury.
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To return to contact sports, the hand may need to be protected for an additional 4-6 weeks with padded splint after the cast is removed.
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Athletes can generally return to sports when they are pain free, have good range of motion of the hand and have signs of healing on x-ray.
Preventing a boxer fracture
The best way to prevent a boxer fracture is to avoid situations in which injury can occur with punching or hitting a hard object in frustration or anger.