Orthopaedics

Boxer’s Fracture

A fracture at the neck of the bones that forms the knuckles of a hand, is called A Boxer’s fracture. A metacarpal bone is in the palm. It extends from small wrist bones to the knuckles of the base of the finger. The site of the break in a boxers’ fracture is near the knuckle. When the fracture occurs at the neck of the fifth metacarpal forming the knuckle of the little finger, is called as the Brawler’s fracture. A Bar Room fracture occurs at the neck of the fourth or fifth metacarpal.

Causes

When a clenched fist is forced against a hard, immovable object like a wall, skull or door; Boxer’s fracture is caused. This fracture may also occur in a free hand striking a hard object.

Treatment

Often angular fractures occur. In sever cases, pins are placed for proper re-alignment. The healing time does not take more than 12 weeks. The swelling starts to decrease in the first two weeks. The patient will also show initiation in forming a fist with the fractured hand. But extending fingers in all directions will take some more time. In general, hard casts are not recommended, but soft casts or splints may be used. These can be removed for small period of time for cleaning activities of the splints and the affected area. Splints may also be removed while taking showers. Medications beyond Ibuprofen and Acetaminophen are not used as the pain is very mild. But complete rehabilitation process takes about 3-4 months. Do not place your fractured hand above your heart level. Warm water may be used to get relief from pain. After removal of casts, try smooth and gentle exercises so that basic functions of the hand is achieved in future.

Prevention

Hand gloves and gloves are used by Boxers and certain athletes (involved in struggle or fight games) to stabilize their hands. This can reduce the risk of pain and injury to a great extent.  A typical athletic tape is used to make Hand wraps. Use of knuckles of middle fingers and index fingers to make straight punches can reduce the risk of injury in Tee-Kwon and Karate practitioners. Make a fist as tight as possible  to prevent any fractures during punching.

Symptoms

  • Pain or tenderness is felt centered to a specific location on the metacarpal bone of the hand.
  • Pain is felt while moving hand or fingers.
  • A sensation of popping or snapping may be felt in the affected bone.
  • Swelling, discoloration or bruising may be seen around the injury site.
  • Deformity may be seen in few cases.
  • Misalignment may be noticed while making a fist with the broken hand.
  • Unusually bending of the finger towards the thumb. This condition may be a serious Boxer’s Fracture.
  • Cut may be seen on the hand. This can also be a serious.

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