Boxer's fracture

Introduction

Metacarpal fractures occur frequently among the general population and report for 40% of all hand fractures. [1] The Fracture of the fifth metacarpal neck also known as Boxers Fracture, named after the classic mechanism of injury in which a direct trauma is applied to a clenched fist or fall directly onto the hand. Boxer's fracture account for 10% of the metacarpal fractures which particularly occur in contact sports. Nearly, one-fourth of cases occur during athletic events. This activity describes the pathophysiology, evaluation, and management of metacarpal hand fractures and highlights the role of the interprofessional team in the management of this condition.

Management

Treatment for a Boxer’s fracture varies based on whether the fracture is open or closed, characteristics of the fracture including the degree of angulation, shortening, and rotation, and other concomitant injuries. Immobilization with an ulnar gutter splint may be the definitive treatment for closed, non-displaced fractures without angulation or rotation, while open fractures, significantly angulated or malrotated fractures or those involving injury to neurovascular structures may require operative fixation.

Hand fractures are common in the general population with relative propensity seen in contact-sport athletes (e.g., boxers, football players) and manual laborers. Metacarpal fractures typically occur secondary to a direct blow or fall directly onto the hand. These fractures commonly occur during athletic activities, particularly in contact sports. Almost one-fourth of cases occur during athletic events. This activity describes the pathophysiology, evaluation, and management of metacarpal hand fractures and highlights the role of the interprofessional team in the management of this condition.

Metacarpal fractures typically occur secondary to a direct blow or fall directly onto the hand.  These fractures commonly occur during athletic activities, particularly in contact sports. Almost one-fourth of cases occur during athletic events.[1][2][3] While a sporting injury is frequently the cause among younger patients, work-related injuries are often the cause in middle-aged patients, and falls are typically the cause in the elderly. Fifth metacarpal fractures often occur secondary to punching a wall or other solid object (hence the eponym, "boxer's fracture").