Boxer’s Fracture

(Fifth Metacarpal Fracture)

by Cynthia M. Johnson, MA

Definition

Boxer's fracture is a break in the long bone that connects the little finger to the wrist. It can take up to 6 weeks to fully heal.

Fractures may either be:

Closed—the fracture does not break the skin
Open—the fracture breaks through the skin

Bones in the Hand

Causes

The fracture may be caused by:

Punching a person or object, such as a wall, with a closed fist
Falls
Contact sports
Squeezing or crushing of the hand

Risk Factors

Things that may raise the risk of this fracture are:

Taking part in fights
Doing contact sports, such as boxing or football
Health problems that weaken bones, such as osteoporosis
Lower muscle mass
Being around violence

Symptoms

A boxer's fracture may cause:

Swelling
Pain
Changes in the way the finger looks
Problems moving the finger

Diagnosis

The doctor will ask about your symptoms and health history. You will also be asked how the injury happened. A physical exam will be done. The finger will be checked.

Images may be taken of your hand. This can be done with x-rays.

Treatment

The fracture is treated based on the level of injury. Options are:

Initial Care

Initial care may be:

Ice to ease pain and swelling
Medicine to ease pain
Antibiotics to treat infection
A splint, brace, or cast to keep the finger in place as it heals
Exercises to help with motion and make the finger strong again

Children's bones have growth plates that let bones grow and harden with age. A child with this type of fracture will need to be checked over time to make sure the bone heals the right way and keeps growing.

Bone Repair

Some fractures cause pieces of bone to come apart. These pieces will need to be put back into the right place. This may be done:

Without surgery—the pieces are moved back into place
With surgery—pins, screws, or plates may be used to connect the bones and hold them in place

Prevention

Most fractures happen due to accidents. Healthy bones and muscles may help prevent injury. This may be done through diet and exercise.

To lower your chance of this type of fracture:

Avoid places where fights may happen.
Wear safety gear when doing sports.
Think about going to a therapist to cope with anger or outbursts.

RESOURCES:

American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

Health Canada
http://www.canada.ca

References:

Hand fractures. Ortho Info—American Academy of Orthopedic Surgeons website. Available at:
...(Click grey area to select URL)
Updated March 2018. Accessed September 20, 2019.

Metacarpal neck fracture—emergency management. EBSCO DynaMed website. Available at: https://www.dyname.... Accessed September 20, 2019.

Wong VW, Higgins JP. Evidence-Based Medicine: Management of Metacarpal Fractures. Plast Reconstr Surg. 2017 Jul;140(1):140e-151e.

Last reviewed September 2019 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
Last Updated: 6/12/2020

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