(Fifth Metacarpal Fracture)
by Deanna M. Neff, MPH
Boxer's fracture is a common name for a fracture of the long bone that connects the little finger to the wrist.
The types of boxer's fractures are:
Fractures may either be:
Boxer's fracture can be caused by:
Risk Factors TOP
Boxer's fractures are more common in men. Other factors that may increase your risk of a boxer's fracture include:
A boxer's fracture may cause:
You will be asked about your symptoms and medical history. A physical exam will also be done. The injured finger will be examined. Tests may include:
Proper treatment can prevent long-term complications or problems with your finger or hand. Treatment will depend on how serious the fracture is, but may include:
Extra support may be needed to protect, support, and keep your finger in proper position while it heals. Supportive steps may include a splint, brace, or cast.
Some fractures cause pieces of bone to separate. These pieces will need to be put back into their proper place. This may be done:
Wound care is an important part of your recovery. This is especially true if you punched a wall, or someone in the mouth, which resulted in a break in the skin.
Children’s bones are still growing at an area of the bone called the growth plate. If the fracture affected the growth plate, your child may need to see a specialist. Injuries to the growth plate will need to be monitored to make sure the bone can continue to grow as expected.
Your doctor may advise:
Check with your doctor before taking nonsteroidal anti-inflammatory medications, such as ibuprofen or aspirin.
Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.
Depending on your vaccination history, you may need a tetanus or other shots.
Rest and Recovery TOP
Healing time varies by age and your overall health. Children and people in better overall health heal faster. In general, it takes up to 6 weeks for a boxer's fracture to heal.
You will need to adjust your activities while your finger heals, but complete rest is rarely needed. Ice and elevating the hand at rest may also be advised to help with discomfort and swelling.
As you recover, you may be referred to physical therapy or rehabilitation to start range-of-motion and strengthening exercises. Do not return to activities or sports until your doctor gives you permission to do so.
To help reduce your chance of boxer's fracture, take these steps:
To help reduce falling hazards at work and home, take these steps:
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Gudmundsen TE, Borgen L. Fractures of the fifth metacarpal. Acta Radiol. 2009;50(3):296-300.
Hand and wrist pain—differential diagnosis. EBSCO DynaMed website. Available at:
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Updated April 14, 2014. Accessed September 5, 2014.
Hand fractures. American Academy of Orthopedic Surgeons Ortho Info website. Available at:
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Updated October 2007. Accessed September 5, 2014.
Poolman RW, Goslings JC, et al. Conservative treatment for closed fifth (small finger) metacarpal neck fractures. Cochrane Database Syst Rev. 2005;(3):CD003210.
Last reviewed August 2014 by Michael Woods, MD
Last Updated: 9/5/2014
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