#Boxers fracture plus#
Splinting or casting done in a position other than the intrinsic plus position may result in contracture at the metacarpophalangeal joint. One prospective study of 25 patients with fifth metacarpal fracture found that treatment with angulation up to 75º by soft wrap and buddy taping resulted in acceptable outcome at 3-year follow-up.4 In a retrospective study of 59 patients with boxer’s fracture who underwent reduction by longitudinal traction and immobilization in a specially molded cast, about 80% of fracture angulation was corrected within 3 to 4 weeks.5Ĭomplications of untreated boxer’s fracture include decreased grip strength as a result of over-angulation. Options include operative procedures and closed reduction with splinting. The ideal treatment of boxer’s fracture remains controversial. The fracture is the result of compression force at the weakest point of the metacarpal bone-the neck. The most common cause of boxer’s fracture is a high-velocity closed-fist strike, although the fracture may result from a fall on a closed fist.2,3 Inexperienced boxers tend to hook their punches, with axial force applied straight to the fourth and fifth metacarpals-the most commonly affected bones-rather than the more stable second and third metacarpals. Boxer’s fracture is one of the most common fractures encountered in the primary care setting and accounts for about 10% of all hand fractures.1
#Boxers fracture professional#
Social services to address his aggressive behavior.īoxer’s fracture is named because of its frequent occurrence in inexperienced boxers it is rare in professional boxers. The patient refused physician-offered assistance of Radiographs after splinting showed satisfactory fracture alignment (C and D). The fracture was managed with closed reduction and an ulnar gutter splint, which resulted in an acceptable outcome. The patient was referred to a hand surgeon. Improper technique enables a preponderance of force to fall on the outer metacarpals. Boxers and other martial artists avoid fractures by keeping their fist and arm bones properly aligned. Radiographs of the left hand showed an angulated fracture of the fifth metacarpal (A and B). A boxer’s fracture is typically caused by striking a hard object with a closed fist, though open-hand strikes can be damaging as well. The left arm was placed in a sling, and the pain was adequately controlled with ibuprofen. Passive and active flexion of the left fingers was impaired. Tenderness was maximal at the fifth metacarpal neck.
On examination, the patient had swelling of the left hand that was most prominent in the fourth and fifth metacarpal area and shortening of the little finger. The symptoms had developed after he had punched a wall during an altercation with a friend. An 18-year-old boy presented to the emergency department with pain and swelling of the left hand and inability to move the fingers.
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