Presence of rotation: this is critical! (see below)Īssess for any associated fractures and/or dislocationsĪlthough it can be treated conservatively, it is relatively unstable, and K-wire fixation is often required for better cosmetic results.Ĭlosed reduction can be achieved by stabilising the proximal part of the metacarpal dorsally and applying pressure to the head of the metacarpal from the palmar aspect while flexing the proximal phalanx 3. Involvement of the articular surface of the MCP joint Location, especially distance along the shaft In addition to stating that a fifth metacarpal fracture is present, a number of features should be evaluated and commented up: Lines may also be drawn along the dorsal cortex to assess palmar angulation 7. When this is not possible the oblique view can be used, however, this results in less accurate measurements that tend to overestimate the degree of angulation 6. The degree of palmar angulation is best assessed on the lateral radiograph, with lines drawn through the medullary canal. Soft tissue gas which should be treated as suspicious for an open injury Intra-articular extension, and degree of articular step-offĭegree of rotation: angulation on AP film implies a degree of rotation Morphology of the fracture: transverse, spiral, comminuted, oblique, etc. Spiral fractures, which are less common, can be harder to visualise 2.įeatures which should be commented upon include: Typically the fracture appears in the transverse plane through the metacarpal neck, with volar angulation of the distal fragment. Plain radiographs are in almost all cases the only imaging required. Spiral fractures or angulation in other directions are also sometimes encountered. In most cases, the neck fracture is typically transversely-orientated and minimally impacted with volar angulation. Typical solid surfaces are walls or human faces, with young adult males by far the most commonly affected group (~95%) 1. See your caregiver or an orthopedic specialist for follow-up care within the next 10 days to make sure your fracture is healing properly.įor more information about boxer's fracture of the hand, please call (918) 494-AOOK (2665).Boxer fractures are an impaction injury that almost always is a consequence of a direct blow with a clenched fist against a solid surface which causes axial loading of the 5 th metacarpal. Elevation and ice help reduce swelling and relieve pain. Keep your hand elevated and apply ice packs for 20-30 minutes every 2 hours to the injured area for the first two days. Do not remove this device or dressing until your caregiver approves. Surgery is sometimes needed.Ī cast, splint, or bulky hand dressing may all be used to protect and immobilize a boxer’s fracture. A boxer’s fracture will usually heal within 6 weeks if it is treated properly and protected from re-injury. Sometimes the fracture rotates out of position. Often the knuckle is pushed down by the impact. Boxer's fracture is usually caused when you hit an object with a clenched fist. The fracture is in the end of that bone which is closest to the little finger. This is the bone in the hand where the little finger attaches. This is commonly called a boxer’s fracture. You have a break (fracture) of the fifth metacarpal bone. Bixby/South Tulsa Cross Creek Center – Physical Therapy.
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