Boxer's Fracture: Symptoms, Causes, Treatment, And More

Blog / Apr 15,2024

Boxing, known for its intensity and agility, is not only a sport but also a metaphor for life's challenges. However, one challenge boxers face, ironically, is a fracture named after them: Boxer's fracture. This injury, though commonly associated with boxing, can occur due to various circumstances beyond the ring. Let's delve into the depths of Boxer's fracture, exploring its causes, symptoms, treatment options, and the road to recovery.

Understanding Boxer's Fracture and its Causes

Boxer's fracture is a break in the neck of the fifth metacarpal bone in the hand, specifically at the knuckle where the finger meets the hand. Despite its name, this injury isn't exclusive to boxers; it can affect anyone who experiences trauma to the hand. The fracture typically occurs when a person strikes a hard object with a closed fist, causing the bone to break. The primary cause of Boxer's fracture is direct trauma to the hand, often resulting from punching a hard surface with a clenched fist. This can happen during physical altercations, accidents, or sports activities. Boxers, martial artists, and individuals engaged in contact sports are at a higher risk due to the repetitive stress placed on their hands. It becomes imperative to wear the right hand wraps while boxing in the ring.

Symptoms of Boxer's Fracture

Recognizing the symptoms of Boxer's fracture is crucial for prompt diagnosis and treatment. Common signs and symptoms include:

  • Pain, swelling, and tenderness around the knuckle of the little finger.
  • Difficulty moving the affected finger or gripping objects.
  • Visible deformity or misalignment of the finger.
  • Bruising or discoloration of the hand.
  • A sensation of grinding or popping in the hand during movement.

Diagnosis, Tests and Treatment of Boxer's Fracture

Understanding of Boxer's Fracture

Image Source: YouTube (Dr. Neil Ebraheim)

A healthcare professional will conduct a physical examination of the hand, assessing for tenderness, swelling, and deformity. X-rays are typically ordered to confirm the diagnosis and determine the extent of the fracture. In some cases, additional imaging tests such as MRI or CT scans may be recommended to evaluate soft tissue damage or assess for any associated injuries. The treatment approach for Boxer's fracture depends on the severity and stability of the fracture, as well as the patient's overall health and lifestyle. Common treatment options include:

  • Immobilization: For stable fractures, wearing a splint or cast may be sufficient to immobilize the hand and promote healing.
  • Reduction: In cases of displaced or unstable fractures, a healthcare provider may need to manipulate the bones back into alignment through a procedure called closed reduction.
  • Surgery: Surgical intervention may be necessary for complex fractures or fractures that fail to heal with conservative measures. Surgical options may include internal fixation with pins, wires, or plates to stabilize the bone fragments.
  • Rehabilitation: Physical therapy exercises and hand therapy can help restore strength, flexibility, and range of motion to the hand following immobilization or surgery.

Recovery and Rehabilitation

The recovery period for Boxer's fracture varies depending on the severity of the injury and the chosen treatment approach. In general, it may take several weeks for the fracture to heal sufficiently to resume normal activities. During this time, it's essential to follow the healthcare provider's recommendations, including:

  • Immobilizing the hand as instructed with splints or casts.
  • Keeping the hand elevated to reduce swelling and promote circulation.
  • Avoiding activities that may exacerbate pain or strain the hand.
  • Gradually reintroducing hand movements and exercises as directed by a physical therapist.
  • Attending follow-up appointments to monitor healing progress and adjust treatment as needed.

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While some instances of Boxer's fracture are unavoidable, there are measures individuals can take to reduce their risk of hand injuries:

  • Wearing protective gear such as gloves or hand wraps during sports or activities that pose a risk of hand trauma.
  • Practicing proper punching techniques and avoiding striking hard surfaces with excessive force.
  • Strengthening the muscles and bones of the hand through regular exercise and conditioning.
  • Seeking prompt medical attention for any hand injuries to prevent complications and facilitate early intervention.

Complications Arising from Surgery on Boxer's Fracture

Boxer's fracture, when severe or complex, may require surgical intervention to ensure proper alignment and stability of the fractured bone. However, like any surgical procedure, there are potential complications to be aware of. Some common complications associated with Boxer's fracture surgery include:


Surgery involves making incisions into the skin, which increases the risk of bacterial contamination and subsequent infection. Healthcare providers take precautions to minimize this risk, such as administering antibiotics and maintaining sterile conditions during the procedure.

Nerve or blood vessel damage

During surgery, there is a possibility of inadvertently injuring nearby nerves or blood vessels, which can lead to numbness, tingling, weakness, or impaired blood flow to the hand. Careful surgical technique and thorough preoperative evaluation help mitigate this risk.

Nonunion or malunion

Nonunion or malunion explanation

Image Source: Slide Player

Despite surgical intervention, there is a chance that the fractured bone may fail to heal properly, resulting in nonunion (failure of the bone ends to fuse together) or malunion (misalignment of the bone). This may necessitate additional interventions such as revision surgery or prolonged immobilization.

Hardware-related issues

If internal fixation devices such as plates, screws, or wires are used to stabilize the fractured bone, there is a possibility of hardware-related complications such as loosening, migration, or irritation of surrounding tissues. In some cases, hardware removal may be required if these issues arise.

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Boxer's fracture is a common hand injury that can occur due to various causes, with direct trauma being the primary culprit. Recognizing the symptoms and seeking timely medical attention is essential for proper diagnosis and treatment. With appropriate care and rehabilitation, individuals with Boxer's fracture can expect a full recovery and a return to their daily activities. Remember, prevention is key, so take steps to protect your hands and minimize the risk of injury in the first place.


How long does it take to recover from Boxer's fracture?

Full recovery from Boxer's fracture typically takes several weeks to months, during which time individuals may experience a gradual improvement in hand function and reduction in pain and swelling. It's important for patients to follow their healthcare provider's postoperative instructions diligently, including adhering to activity restrictions, attending follow-up appointments, and participating in rehabilitation programs as prescribed.

Can I allow the fracture to heal on its own?

Simple, non-displaced fractures may heal with conservative measures such as immobilization and rest, especially if diagnosed and treated promptly. However, more complex or displaced fractures often require surgical intervention to realign the bone fragments and ensure optimal healing.