Boxer’s Fracture


Believe it or not, there is a proper way to throw a punch. Now don’t get me wrong, I’m not condoning violence in anyway, but if you do find yourself throwing a punch you need to be cautious as you could very easily harm yourself in the process. You may have heard the term “boxer’s fracture” or “boxer’s injury”. It is characterized by severe pain, swelling, and bruising most often on the lateral aspect of your hand. You can acquire this injury with any excessive force to the knuckles and/or bones within your hand. Let’s dive a bit deeper.

A Boxer’s fracture is a musculoskeletal condition that arises from the fracture on the fifth metacarpal bone. The fifth metacarpal bone is located on the outside of the hand at the base of the pinky finger. Overtime the name of the condition has been widely used to refer to fractures even on the 4th and sometimes the 3rd metacarpals.

The metacarpal bones of the hand serve as a connection between the bones of the wrists and of the fingers. Each metacarpal bone has three main parts: “the head, the neck, and the base.” The head of these metacarpal bones form the knuckle. In boxer’s fracture, the “neck” of the metacarpal is affected because among the three parts, this is the weakest, and thus cannot withstand as much pressure as the others.

COMMON CAUSES

As the name implies, this condition is mainly obtained by punching a hard object with closed fists. In some instances, you can acquire the injury even if the fist is not closed during contact with a hard object. As long as the injury is on the neck of the metacarpal region, this may still be considered a boxer’s fracture.

TYPICAL SIGNS & SYMPTOMS

As in most types of injury, a person with boxer’s fracture is bound to experience pain and swelling of the target area. Some other related signs and symptoms on the affected part may include:

  • tenderness

  • redness

  • bruises

  • discoloration

  • popping or snapping sensations with movement

Because a fracture changes and displaces the general location of the bone and its surrounding parts, there may also be slight deformity of the hand, especially when the affected hand is closed into a ball of fist. The knuckle may show unusual bumps that may not be seen on the unaffected hand.

Pain is the most common symptom of this condition. You can reproduce the pain by pressing on the site of the fracture. Typically described as a sensation that feels like holes within the bone, the pain does not go away even when the hand is in resting position.

TREATMENT OPTIONS

For first aid treatment, immobilize the area and ensure that the hand is in resting position. Place a ice pack over the area for at least 20 minutes or until the person feels number because of the coldness of the pack.

To further reduce inflammation and help facilitate healing, the person can take NSAIDs (anti-inflammatory medication like Ibuprofen). This will not only get rid of the symptoms associated with inflammation but will also help temporarily reduce or eliminate the pain. This is particularly helpful if the pain seems unbearable for the person.

Splinting and wrapping by an orthopedic specialist may be needed, however care must be taken not to prolong this stage more than necessary as prolonged immobilization may cause stiffness and rigidity. In some severe cases, surgical fixation may be needed. Healing may take anywhere from six (6) to eight (8) weeks.

Physical therapy also plays an important role in the rehabilitation of the person’s function. Aside from modalities like cryotherapy and therapeutic ultrasound, exercises such as stretching and strengthening exercises can help improve the flexibility of the fingers and wrists. This can also contribute in improving the hand grip. During the later stages of healing, functional training for the affected hand may also be done.

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