What a Boxer’s Fracture Can Mean for You

A boxer’s fracture is a term used to indicate a fracture of the metacarpal bones of the hand. A fracture is the same thing as a break, so one or more of the 27 small bones in the hand are broken. The little finger is the one most prone to this type of injury and the break usually occurs at the bottom of the finger at the knuckle joint.

Also called a brawler’s fracture, scrapper’s fracture or bar room fracture, a boxer’s fracture is the result of hitting something solid with your fist and injuring a metacarpal in the process. Some would argue that a boxer is too well trained to receive this type of injury and that’s why they prefer to call it a brawler’s fracture.

What causes a boxer’s fracture?

A boxer’s fracture is typically caused by one of these situations:

• Hitting a wall with a fist
• Hitting someone hard
• Accident resulting in a crushing injury
• Harsh twisting of a finger
• Falling on an outstretched hand (FOOSH injury)
• What are the symptoms of a boxer’s fracture?

“You probably know something is wrong with your hand by not being able to close it or grip something, and you’ll notice the knuckle may be extended or depressed or the little finger is rotated strangely,”

said Advance ER physician Dr. Ronnie Shalev. “It might be hard to know there is something broken, however, because of the swelling. A quick X-ray and an ER examination will determine the extent of the damage.”

What is the treatment for a broken hand?

Depending on the severity of the injury, a boxer’s fracture can be treated in the following ways:

• Wrap with Coban bandage
• Splint
• Closed reduction – putting bones back into place without opening the skin
• Open reduction – surgical procedure of opening the skin to repair the bones
• Wires – inserted through skin to stabilize closed reduction
• Pins – either temporary or permanent that can hold the bones in place
• Plate – surgical procedure to add a plate to a serious fracture while still allowing movement

“The ideal, of course, is to wrap the finger with a self-sticking compression bandage so the finger can’t be bumped or injured and it still allows for a little bit of movement, which is important to keep away stiffness and pain,” said Dr. Shalev. “However, worse cases may require an orthopedic surgeon and surgery to repair. Because of the location, sometimes the stiffness and impaired joint function can last a lifetime.”

Where can I find an orthopedic surgeon?

If your boxer’s fracture has a displaced or rotated small finger with a knuckle joint that overlaps the ring finger or is sunken, you may need to visit an orthopedic surgeon to determine the treatment options. Waiting for an appointment with a specialist can be a difficult thing when you’re in pain.

“At Advance ER, we have an amazing program called SPECIALIST NOW™ where you can have fast access to an orthopedic surgeon,” said Dr. Shalev. “The consultation is available to you at no additional office charges from the surgeon.”

What’s the first thing I should do if I injure my hand?

“If you have injured your hand and it is swollen and painful, apply ice and elevate it. If you are in pain, come to Advance ER for a no wait consultation that gives you rapid results. Painkillers may be recommended along with ice, elevation and rest,” said Dr. Shalev.