Boxers Fracture

Hand Fracture of the Pinkie or Ring Finger

Man and woman exercising with punchingballs
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What is a Boxer's Fracture?

The boxer's fracture is a broken bone of the hand, classically at the base of the small finger or the ring finger. The boxer's fracture is a break that occurs in the region of the bone called the metacarpal neck. The metacarpal is the bone in the palm of the hand that extends from the small bones of the wrist the knuckle at the base of the finger. The site of the break in a boxers' fracture is near the knuckle.

How does a boxer's fracture occur?

Most often boxer's fractures are seen after punching a person or an object such as a wall. While the injury is most often a punching motion, patients can also sustain this injury with non-punching types of motions. Other causes can be from trying to break a fall with your hand, having your hand crushed in an accident, violent twisting of the hand or finger, or from contact during sports.

What are the symptoms of a boxer's fracture?

Patients who sustain a boxer's fracture commonly complain of pain and swelling at the base of the small finger. A depressed knuckle is the common sign of boxer's fracture. There is also often a bump over the back of the palm just below the small finger knuckle. This bump may not go away even with proper treatment. However, the bump does not interfere with proper or hand and finger function.

How will boxer's fracture be diagnosed?

It is important to get this fracture treated, or you may lose function of your finger permanently.

You will visit your primary care doctor or an urgent care clinic if this is your only injury, although if you've had a fall or other injuries you may go to an emergency room. The doctor will do a physical exam and listen to how you sustained the injury. She will check your fingers and ensure you haven't had any nerve damage to the hand.

You'll probably have an X-ray to confirm the fracture.

What is the treatment of a boxer's fracture?

Depending on the severity of the boxer's fracture, these can be treated either by casting or surgery. Without surgery, the doctor will realign the bones and place your finger in a splint or cast, so it is immobilized while it heals.You'll probably have a repeat X-ray in a week to ensure the bones are being kept aligned for healing. The cast is usually kept on for three to six weeks.

If surgery is needed, the usual treatment is with implanting small pins through the skin to secure the bones in place. These may remain in after the bone has healed or they may be removed.

You may be given physical therapy after the cast has been removed or assigned exercises to use. You will have lost some range of motion and strength while the hand was in the cast and you may have difficulty at first with fine motions of the hand. Physical therapy can target improving grip strength and finger strength and range of motion.

More: Physical Therapy for Boxer's Fracture


Hand Fractures, American Society for Surgery of the Hand, October, 2007.

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