Boxers Fracture

What is Boxers Fracture

Boxers Fracture is a break (fracture) of the bone in your hand that connects your little finger to your wrist (fifth metacarpal). This type of fracture usually happens at the end of the bone, closest to the little finger. The knuckle is often pushed down by the impact.

In some cases, only a splint or brace is needed, or you may need a cast. Casting or splinting may include taping your injured finger to the next finger (buddy taping). You may need surgery to repair the fracture. This may involve the use of wires, screws, or plates to hold the bone pieces in place.

What are the causes?

This injury may be caused by:

  • Hitting an object with a clenched fist.
  • A hard, direct hit to the hand.
  • An injury that crushes the hand.

What increases the risk?

This injury is more likely to occur if:

  • You are in a fistfight.
  • You have certain bone diseases.

What are the signs or symptoms?

Symptoms of this type of fracture develop soon after the injury. Symptoms may include:

  • Swelling of the hand.
  • Pain.
  • Pain when moving the fifth finger or touching the hand.
  • Abnormal position of the finger.
  • Not being able to move the finger.
  • A shortened finger.
  • A finger knuckle that looks sunken in.

How is this diagnosed?

This injury may be diagnosed based on your symptoms, especially if you had a recent hand injury. Your health care provider will perform a physical exam, and you may also have X-rays to confirm the diagnosis.

How is this treated?

Treatment for this injury depends on how severe it is. Possible treatments include:

  • Closed reduction. If your bone is stable and can be moved back into place, you may only need to wear a cast or splint or have buddy taping.
  • Open reduction with internal fixation (ORIF). This may be needed if your fracture is far out of place or goes through the joint surface of the bone. This treatment involves open surgery to move your bones back into the right position. Screws, wires, or plates may be used to stabilize the fracture.

You may need to wear a cast or a splint for several weeks. You will also need to have follow-up X-rays to make sure that the bone is healing well and staying in position. After you no longer need the cast or splint, you may need physical therapy. This will help you to regain full movement and strength in your hand.

Follow these instructions at home:

If you have a cast:

  • Do notstick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
  • Check the skin around the cast every day. Report any concerns to your health care provider. You may put lotion on dry skin around the edges of the cast. Do notapply lotion to the skin underneath the cast.

If you have a splint:

  • Wear it as directed by your health care provider. Remove it only as directed by your health care provider.
  • Loosen the splint if your fingers become numb and tingle, or if they turn cold and blue.

Bathing

  • Cover the cast or splint with a watertight plastic bag to protect it from water while you take a bath or a shower. Do notlet the cast or splint get wet.

Managing pain, stiffness, and swelling

  • If directed, apply ice to the injured area (if you have a splint, not a cast):
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Move your fingers often to avoid stiffness and to lessen swelling.
  • Raise the injured area above the level of your heart while you are sitting or lying down.

Driving

  • Do notdrive or operate heavy machinery while taking pain medicine.
  • Do notdrive while wearing a cast or splint on a hand or foot that you use for driving.

Activity

  • Return to your normal activities as directed by your health care provider. Ask your health care provider what activities are safe for you.

General instructions

  • Do notput pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
  • Keep the cast or splint clean and dry.
  • Do notuse any tobacco products, including cigarettes, chewing tobacco, or electronic cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
  • Take medicines only as directed by your health care provider.
  • Keep all follow-up visits as directed by your health care provider. This is important.

Contact a health care provider if:

  • Your pain is getting worse.
  • You have redness, swelling, or pain in the injured area.
  • You have fluid, blood, or pus coming from under your cast or splint.
  • You notice a bad smell coming from under your cast or splint.
  • You have a fever.
  • Your cast or splint feels too tight or too loose.
  • You cast is coming apart.

Get help right away if:

  • You develop a rash.
  • You have trouble breathing.
  • Your skin or nails on your injured hand turn blue or gray even after you loosen your splint.
  • Your injured hand feels cold or becomes numb even after you loosen your splint.
  • You develop severe pain under the cast or in your hand.
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