Fractures or broken bones, are common injuries that occur in the elbows, wrists, hands, and fingers. They are usually the result of a fall or other accident. Thinning of the bones from various medical conditions can also predispose one to fractures. Symptoms of fractures may include pain, swelling, and deformity.

The “Boxer’s Fracture”

A boxer’s fracture is defined as a break through the bones of the hand that form the knuckles. Some doctors refer to this type of injury as a “brawler’s fracture”, because a boxer is not likely to get this injury. The assumption is that less well-trained brawlers do not know how to punch without hurting themselves.

More About Hand Fractures

The metacarpal bones in the hand connect the bones in the finger to the bones in the wrist. There are 5 metacarpal bones — 1 to connect each finger to the wrist. All of the metacarpal bones have the same anatomic structure: each consists of a base, a shaft, a neck, and a head. The base of the metacarpal bone is the portion that attaches to the bones of the wrist. The shaft is the long, slender portion of the bone. The neck is the portion of the bone that connects the shaft to the head. The head of the metacarpal bone connects the metacarpal bone to the bone of the finger. The head of the metacarpal bones form the knuckle of an enclosed fist. A boxer’s fracture involves a break in the neck of the metacarpal.

Boxer’s fractures most commonly occur in the metacarpal bones that connect the ring finger or the little finger to the wrist. These are known as the fourth and fifth metacarpal bones. Some doctors include breaks in the neck of the second and third metacarpal bones in the definition of a boxer’s fracture. The second metacarpal bone connects the index finger to the wrist, and the third metacarpal connects the middle finger to the wrist.

Initial treatment

The initial treatment of a fracture consists of pain control and protection with a splint or cast. Depending on the type and severity of the fracture, splint or cast treatment is continued or surgery is recommended. Therapy to regain motion, strength, and function of the fractured bone is started as soon as the fracture is stable enough to allow it.