Boxers fracture - causes, symptoms and treatment
Medically Reviewed By : Dr K. Hari Chandana
MBBS, MS ORTHOPAEDICS
( Fellowship in Trauma, Fellowship in Pain Management )
Introduction
A boxer’s fracture is a specific type of hand fracture that involves the fifth metacarpal bone in the hand, which connects the small finger (pinky) to the wrist. It is named as such because it is a common injury among boxers who may sustain it from punching improperly or without proper hand protection.
The fracture typically occurs when the hand impacts an object with a clenched fist, leading to a forceful bending of the fifth metacarpal bone. This can happen during a physical altercation, sports activities, or even accidentally striking a hard object.
Signs and symptoms include:
- Pain: Sharp pain at the base of the little finger or along the pinky side of the hand.
- Swelling: The area around the fracture may become swollen and bruised.
- Deformity: The hand may appear crooked or angulated, especially when trying to make a fist.
- Limited range of motion: It may be challenging to move or use the affected hand and fingers properly.
- Tenderness: The area around the fracture will be sensitive to touch.
If you suspect a boxer’s fracture, it is essential to seek medical attention promptly. A physician will likely perform an examination, order X-rays or other imaging tests, and determine the appropriate course of treatment.
Boxer's Fracture Causes
Boxer’s fractures are most commonly caused by direct trauma or forceful impact to the hand when it is clenched in a fist. Some common causes of boxer’s fractures include:
- Punching without proper technique: The fracture often occurs in individuals who punch improperly or without proper hand protection. This can be seen in inexperienced boxers or individuals who engage in physical altercations without proper training.
- Sports injuries: Boxer's fractures can also occur in various sports that involve hand contact, such as martial arts, football, hockey, and basketball.
- Accidental trauma: A person may sustain a boxer's fracture from accidentally striking a hard object, like a wall or a door, with a closed fist.
- Falls: Falling and landing with an outstretched hand or a clenched fist can result in enough force to cause a fracture.
- Physical altercations: Being involved in a fight or an altercation where the hand is used to strike another person or object can lead to a boxer's fracture.
- Workplace accidents: Certain occupations that involve heavy manual labor or use of hand tools may increase the risk of hand injuries, including boxer's fractures.
- Osteoporosis: In older adults or individuals with weakened bones due to conditions like osteoporosis, even a relatively minor impact can lead to a boxer's fracture.
It’s essential to take precautions and wear appropriate hand protection during activities with a risk of hand injuries. This includes using proper boxing gloves, hand wraps, or other protective gear when engaging in contact sports or martial arts. In case of any significant hand trauma or pain after an injury, seeking prompt medical attention is crucial to assess and treat the condition properly.
Boxer's Fracture Symptoms
The symptoms of a boxer’s fracture can vary depending on the severity of the injury, but common signs to look out for include:
- Pain: Pain is the most noticeable symptom of a boxer's fracture. The pain is usually localized to the hand, specifically around the base of the little finger (pinky) or along the outer side of the hand.
- Swelling: Swelling often occurs around the injured area due to the body's natural response to trauma. The hand may appear swollen and puffy.
- Bruising: Bruising (discoloration of the skin) may develop around the fracture site, which is caused by bleeding beneath the skin as a result of the injury.
- Deformity: In some cases, the fracture can cause a visible deformity in the hand. The affected finger may look crooked or angulated, especially when attempting to make a fist.
- Tenderness to touch: The area around the fracture site will be sensitive and tender to touch. Even gentle pressure may cause discomfort.
- Limited range of motion: A boxer's fracture can affect the hand's ability to move properly. The injured individual may have difficulty flexing or extending the fingers fully.
- Numbness or tingling: In more severe cases or when there is nerve involvement, the injured person may experience numbness or tingling sensations in the hand or fingers.
It’s important to note that some people may experience a boxer’s fracture with only mild symptoms, while others may have more severe pain and swelling. If you suspect a boxer’s fracture or if you experience any of the above symptoms after an injury involving the hand, it is crucial to seek medical attention promptly. A healthcare professional can perform a thorough examination, order imaging tests (such as X-rays), and recommend the appropriate treatment plan based on the severity of the fracture. Early diagnosis and treatment can lead to better outcome and faster recovery.
Boxer's Fracture Treatment
The treatment for a boxer’s fracture depends on the severity and alignment of the fracture. Here are the common approaches to treating a boxer’s fracture:
- Closed Reduction and Immobilization: If the fracture is not significantly displaced (the bone pieces are still in alignment), a doctor may perform a closed reduction. This involves manipulating the bone fragments back into their proper position without surgery. After the reduction, the hand will be immobilized using a splint or cast to keep the bones stable while they heal. Immobilization typically lasts for about 3 to 6 weeks.
- Surgery:/ In more severe cases with significant displacement or if the closed reduction is not successful, surgical intervention may be necessary. During the surgery, the surgeon will realign the fractured bone fragments and fix them in place using pins, screws, or plates. After surgery, the hand will still be immobilized with a splint or cast for several weeks to aid in healing.
- Pain Management: Over-the-counter pain medications like acetaminophen or ibuprofen can help manage pain and reduce inflammation. Your doctor may also prescribe stronger pain medications if needed.
- Elevation: Keeping the hand elevated above heart level can help reduce swelling and promote healing.
- Physical Therapy: Once the fracture starts to heal, your doctor may recommend physical therapy exercises to improve hand mobility, strength, and flexibility.
- Follow-up Care: Regular follow-up appointments with your healthcare provider are essential to monitor the healing progress and make sure there are no complications.
- Avoiding Stress on the Hand: During the healing process, it's crucial to avoid putting excessive stress on the injured hand. Activities that could worsen the fracture should be avoided until the doctor gives the green light for resuming regular activities.
The choice of treatment will depend on factors such as the type and location of the fracture, the patient’s age, overall health, and the extent of displacement. It is essential to follow your doctor’s recommendations and adhere to the prescribed treatment plan to promote proper healing and minimize the risk of complications. Delaying or neglecting treatment may lead to long-term hand problems and functional limitations.