What is Boxer’s Fracture?
Boxer fracture is a fracture of the metacarpal bone which locates on the base of the little finger.
It generally occurs when somebody punch a hard object. Falling down over the hand, crushing injuries in between solid surfaces, or some physical sport traumas may also cause Boxer’s fracture. These fractures, which are usually seen in healthy individuals, tend to be more easily occurred in some cases whom they have osteoporosis.
What are the complaints on the Boxer’s fracture?
- Because fracture generally occurs in angulation at the fracture site, there is a swelling and a visible bump over the hand.
- There is pain, tenderness, and swelling on the hand where generally locates at the base of the little finger. Limitation of the motion is prominent especially on little and ring fingers.
- The knuckle on the base of the little finger may be lost.
- There may be numbness or dullness over the hand.
- Bruising and lacerations may be obvious around the fracture site.
How does the doctor make diagnosis for the Boxer Fracture?
Once the doctor exams the patient followed by an x-ray evaluation, he/she easily put the diagnosis.
If necessary, it may be necessary to use advanced imaging techniques to evaluate angulation on the fracture.
How to treat a Boxer Fracture?
First of all, cold application is useful to temporarily relieve pain and to manage swelling. Keeping the hand above the heart level (elevation) before seeing the doctor is also important to reduce the swelling. Trying to keep to carrying on to daily living with this kind of traumatized hand for a long time may cause to be resulted in permanent deformities and functional disabilities because of the changes in bone itself, muscles, tendons, ligaments, vessels, or nerves.
The aims of the treatment are to try to correct the fracture and to restore normal anatomy as much as possible, to ensure the fracture healing, and to let the patient to return back to the old functional level of the hand. If the fracture can be reduced with the special manipulations in painless methods, it is secured with a cast or splint to protect the corrected position till the fracture healing will be completed. Surgical treatment may be taken into consideration when the broken bone is not able to be corrected by manipulated interventions. In surgical treatment, various wires, screws, and/or plates are used to fix the fracture after the fracture position is maintained into normal anatomy.
It usually takes 10-12 weeks to securely heal the fracture and regain normal function of the hand. However, the healing time and progress may vary from patient to patient. Factors such as general health status and the properties of the fracture type may also affect the healing quality.
Prof. Dr. Eftal Gudemez
Orthopedics and Traumatology
Hand Surgery and Microsurgery
What is the role of physiotherapy after Boxer’s Fracture?
Serious drawbacks may be problem after Boxer’s fracture both in conservative casting methods and in surgical ways. If the hand gets stiff and gets lost in range of motion after such long time immobilization inside of the cast or after insufficient early mobilization attempts in postsurgical time period, proper physiotherapy programs are indicated. The possible problems of this kind of fracture which need hand therapy are as follows:
- Stiffness, and decreased range of motions in the joints around the fracture
- Weakness
- Swelling
- Pain
Physical therapy and rehabilitation modalities may be necessary in order to avoid or treat these problems.