Boxer's fracture

A boxer's fracture is a break in the metacarpal of the little finger. Metacarpals are the long bones in the hand that connect the fingers to the wrist. A boxer's fracture refers to a break in the end of the bone closest to the knuckle, which is called the metacarpal neck.

This type of fracture most commonly occurs when someone hits a hard surface (or another person) with a clenched fist. Since most people strike in a roundhouse fashion, the first point of bone contact on a punch is the metacarpal bone of the little finger.

Symptoms

Common symptoms include pain, tenderness, and swelling around the knuckle of the little finger. Bruising and loss of knuckle contour are also common, and extending the finger can be difficult. In severely displaced fractures, the fingers may overlap (or scissors) when flexed.

A boxer's fracture can also occur when a person stumbles and tries to break their fall with a fist closed to the ground. Occasionally, direct trauma to the hand can also cause this injury.

Treatment

Most boxer fractures can be treated with a cast or brace to stabilize the fracture while it heals. If the knuckle is severely deformed, a procedure called closed reduction may be necessary to push the fracture back into the correct position before casting. For severe displacement, finger scissors, or multiple metacarpal fractures, surgery may be recommended.