Boxer's Fracture

A boxer’s fracture is a fracture (broken bone) of the hand. More specifically, it is a fracture of the neck of the fifth metacarpal (a bone in the “pinky finger") (Figure 1). It is referred to as a boxer’s fracture because, most commonly, it occurs when people punch something.

Figure 1
The fifth metacarpal
Figure 2
A sign of a boxers fracture, with the small finger crossing over another finger
Figure 3
An example of a cast worn after a boxers fracture

Causes

The most common cause of a boxer’s fracture is the force applied to the fifth metacarpal bone when the fist punches something while in a clenched position. Less commonly, this fracture may also occur from getting the hand crushed.

Signs and Symptoms

Most people with a boxer’s fracture have pain and swelling concentrated in the hand. The hand and finger may be crooked or deformed. The pinky finger may be difficult to straighten or sometimes can cross over the other fingers (Figure 2). There also may be difficulty moving the fingers, either with or without pain.

Treatment

To determine if you have a fracture, your doctor will likely take an x-ray. Treatment varies depending on how far out of place the bone is located. If it is out of place too far, the doctor or provider may offer to push it back into place and cast it or may offer surgery.

  • Casting: Typically, it will be about 3-6 weeks in a cast or similar device (Figure 3). After the cast is taken off, you’ll be encouraged to get the fingers moving.
  • Surgery: This is frequently done with pins through the skin, but there may be other options depending on the specific fracture. Sometimes, the surgeon will recommend therapy afterwards to help with motion.


© 2018American Society for Surgery of the Hand

This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand.Find a hand surgeon near you.

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