Hand Fracture: Fifth Metacarpal (Boxer's) Fracture

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KEY POINTS

• A boxer’s fracture is a break or crack in the long bone that attaches to the pinky finger.
• Treatment may include surgery, a splint or cast, and special exercises to help your hand get stronger and more flexible.
• Follow the full course of treatment your healthcare provider prescribes.

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What is a boxer’s fracture?

A boxer’s fracture is a type of hand fracture. It is a break or crack in the long bone (fifth metacarpal) that attaches to the pinky finger. The break may be just a bend or small crack in the bone, or the bone may break into pieces or shatter. Some fractures may stick out through the skin.

The long bones in the hand are called metacarpals.

What is the cause?

A boxer’s fracture can happen from falling or hitting something with your fist. A fracture may also be the result of a medical condition that causes weak or brittle bones.

What are the symptoms?

Symptoms may include:

• Pain, swelling, bruising, or tenderness on the pinky finger side of the hand that happens right after the injury
• Pain when the injured area is touched
• Pain or swelling that keeps you from using your hand
• A bump on the side of the hand
• An area of the hand that is cold, pale, or numb
• A change in the shape of the hand

How is it diagnosed?

Your healthcare provider will ask about your symptoms and how the injury happened. Your provider will examine you. Tests may include:

• X-rays of the hand
• CT scan, which uses X-rays and a computer to show detailed pictures of the bones
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the bones

How is it treated?

The treatment depends on the type of fracture.

• If you have an open wound with the fracture, you may need treatment to control bleeding or prevent infection.
• If the broken bone is crooked, your healthcare provider will straighten it. You will be given medicine first so the straightening is less painful.
• Sometimes surgery is needed to put the bones back into the right position.
• Your provider may put your hand and forearm in a cast or splint to keep your hand from moving while it heals. If you have a cast, make sure the cast does not get wet. Cover the cast with plastic when you bathe. Avoid scratching the skin around the cast or poking things down between the cast and your skin. This could cause an infection.

With treatment, the fracture may take up to 6 weeks to heal. You may need to do special exercises to help your hand get stronger and more flexible. Ask your healthcare provider about this.

How can I take care of myself?

Follow the full course of treatment your healthcare provider prescribes. Also:

• To keep swelling down and help relieve pain, your healthcare provider may tell you to:
  • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time for the first day or two after the injury.
  • Keep the hand up on pillows so that it is above the level of your heart when you sit or lie down.
  • Take pain medicine, such as ibuprofen, as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take this medicine for more than 10 days.

Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent a boxer’s fracture?

Try to avoid hitting hard objects with your fist.