Have you ever slammed your hand into a wall in anger? Or have you ever been hit hard while playing sports? Sometimes, when that happens, you can break a bone in your hand, especially the bone on the side of your ring finger. Today, we're going to talk about this type of fracture, which doctors call a 'Boxer's Fracture.'
What is a Boxer's Fracture?
Simply put, a boxer's fracture is a break in your hand. It is a type of metacarpal fracture.
The back of your hand has long, knobby bones that you can feel when you touch them, and that's what we call the metacarpals. These are the bones that connect your thumb and the phalanges of your other fingers to your wrist.
A boxer's fracture is a break in the fifth metacarpal bone that connects your pinkie finger to your wrist . Specifically, the end of that bone that connects to the knuckle, the 'neck' part, is broken.
Most of the time, treatment for a fracture like this involves immobilizing the arm with a splint or cast. However, if the fracture is severe, especially if it is accompanied by other injuries, surgery may be necessary.
Open and Closed Boxer's Fracture
Now your doctor will classify this fracture as an 'open' or 'closed' fracture.
An open fracture is when the broken bone breaks through your skin and sticks out. This is a bit dangerous because it takes longer for the wound to heal and there is a higher chance of infection.
In a closed fracture, the bone is broken, but the skin is not broken. It is also serious, but the risk of complications is lower than that of an open fracture.
Displaced Boxer's Fracture
Two other terms that doctors use are 'displaced' and 'nondisplaced'.
A displaced fracture is when the two pieces of a bone break and are pushed back and forth, out of place, leaving a large gap between them. Simply put, the bone is stretched and not straight.
In a nondisplaced fracture , the bone is broken, but the pieces haven't moved too far, and are still in roughly the same alignment. Displaced fractures usually require surgery.
How common is boxer's fracture?
This boxer's fracture is actually the most common type of metacarpal fracture in the hand. In fact, about a quarter (about 25%) of all metacarpal fractures in the hand are of this type.
What are the symptoms of a boxer's fracture?
Okay, now let's see what the symptoms of a boxer's fracture are.
- Sharp pain: This is the main thing. It hurts where the hand was.
- Swelling: The injured part of the hand swells up a lot.
- Pinkie finger going over the other finger: Your pinkie finger may appear to go over or behind your ring finger. This is called a 'rotational deformity' . It means the finger is twisted.
- Tenderness: The injured area will hurt if you touch or press on it.
- Difficulty moving or using the hand: Difficulty in performing tasks with the hand, bending or extending the fingers.
- Bluish discoloration: The skin at the site of the injury may turn blue or purple.
What causes boxer's fractures?
The main cause of this is when you hit your hand hard against a wall or door with your fist . Some people do this when they are angry. This is when it happens most. The name 'boxer's fracture' is derived from the fact that boxers often suffer from this injury. Also, a hard blow to the back of your hand can cause this type of fracture.
Who is more at risk for this?
Anyone can break the fifth metacarpal bone on the side of the big toe. But some people are at a slightly higher risk. Check out who this is:
- People between the ages of 10 and 40: This is seen a little more often in this age group.
- Athletes: Especially those who play contact sports that use their limbs, such as boxing and martial arts.
- People with osteoporosis: Osteoporosis is a disease that causes bones to become brittle and weak. People with this condition can break their bones even with a minor injury.
How do you recognize a boxer's fracture?
When you go to a doctor, they will first examine your hand. The doctor may think it's a boxer's fracture just by touching it or just by looking at it. You need to tell the doctor exactly what happened before you injured your hand and how you first noticed the symptoms.
What are the diagnostic tests?
The doctor will take X-rays of your hand. The X-ray will show exactly where the fifth metacarpal bone is broken and what the fracture looks like.
Sometimes, especially if you need to have surgery, you may also have a CT scan (Computed Tomography - CT scan) . A CT scan can take a three-dimensional (3D) picture of your bones and the surrounding tissue.
How are boxer's fractures treated?
Your doctor will recommend treatments to help your bone heal. The type of treatment you need will depend on the type of boxer's fracture you have and whether you have other injuries. The most common treatments are:
Immobilization
If the boxer's fracture is not too severe, meaning the bone fragments are not too far apart (nondisplaced fracture), you may only need to keep your arm in a splint or cast. Most people will need to keep their arm in this position for three to six weeks . In between, they will take X-rays to make sure the bones are healing properly.
Manual correction (Closed reduction)
For a more severe boxer's fracture, you may need to have a procedure called a 'closed reduction' to realign the broken bone fragments. In this procedure, the doctor will press the back of your hand and bring the broken bone fragments back into place. While doing this, you will not feel any pain and may do one of the following:
- Local anesthetic: This numbs only the area around the fracture .
- Sedatives: This will make you feel relaxed.
- General anesthesia: This means you won't feel anything, you'll be asleep.
After realigning the bones in this way, the doctor will immobilize your arm in a splint or cast.
Boxer's fracture surgery
Most people do not need surgery for a boxer's fracture.
But if you have an open fracture, a displaced fracture, or a comminuted fracture, your doctor may recommend surgery. Also, if there is damage to the bone as well as other surrounding tissues, surgery may be necessary. In particular, if the fracture has caused your big toe to move over the other toe (malrotation), surgery is more likely to be required.
The surgeon sets your bone pieces back in place and fixes them together, so that they fit together properly. This is usually done through an 'internal fixation' . This means that the surgeon inserts pins, screws, or a plate into your bone to hold the pieces together. After the bone heals, you may need to have another surgery to remove the fixation.
Possible complications from surgery
The main complications that can occur after boxer's fracture surgery are:
- Malunion: This occurs when the broken bone fragments do not fit together properly as they heal. This can change the shape of the hand and reduce the function of the hand.
- Nonunion: Sometimes the bone pieces may not fit together properly, or they may not fit together at all.
- Osteomyelitis: If you have an open fracture, meaning the bone has broken through the skin, you are at higher risk of developing a bacterial infection.
- Stiffness in the hand: People who have had a boxer's fracture usually feel stiffness around the broken bone. This stiffness can be reduced with home exercises and occupational therapy .
- Acute Compartment Syndrome (ACS): This is a dangerous condition. The pressure inside the muscles of the arm increases, and blood flow can be impaired. This can lead to permanent damage to the muscles and nerves.
How soon will I feel better after treatment?
It may take a few weeks for your symptoms to subside. The pain will start to subside in a few days. But it will take about six weeks for your bone to regain full strength.
Depending on the type of treatment you received, you may be able to move and use your hand again in a few weeks.
But remember, if you have unbearable pain and it doesn't subside, you should see a doctor immediately.
What can you expect if you have a boxer's fracture?
You can most likely make a full recovery from a boxer's fracture.
You may also need occupational therapy to regain strength and movement in your hand.
How long does it take for a boxer's fracture to heal?
Most people take about a month or two to heal from a boxer's fracture. How long it takes for you depends on the severity of the fracture and the treatment you received.
In fact, the time it takes for a body to heal varies from person to person. Ask your doctor or surgeon how long it will take depending on your condition.
Will I be unable to go to work/school because of this?
You may not be able to go to work or school until your hand heals. This is especially difficult if the fracture occurred in your dominant hand, which is the hand you use most often, such as the hand you write with or do other work with.
Most people can resume physical activities (such as sports) after about eight weeks .
However, you should always consult a doctor or surgeon before starting anything again. Especially if your bone was broken while playing a sport or doing something specific, be sure to seek advice before starting again.
How can we reduce the risk of this kind of accident?
To reduce the risk of this type of injury, follow these simple safety tips:
- When you are angry or upset, never hit the walls, the floor, or any other hard object. This is the most important thing.
- Always wear a seatbelt when riding in a vehicle.
- Wear appropriate protective equipment for every activity and sport.
- Follow a diet and exercise plan that helps maintain your bone health.
- If you are over 50 years old, or if someone in your family has osteoporosis, talk to your doctor and consider getting a bone density test .
When do you need to go to a hospital urgently?
If you think you have a boxer's fracture (or any other bone fracture), you should see a doctor as soon as possible. If you have any of the following symptoms, go to the emergency room immediately:
- Unbearable pain.
- If you can't move your hand or fingers normally.
- If the appearance of your hand has changed significantly.
- If your bone is sticking out through your skin.
- Swelling.
- If you have started to experience new blueness along with these other symptoms.
What should I ask the doctor?
It's a good idea to ask these questions when you see your doctor:
- What type of fracture do I have?
- Will I need surgery?
- How long will I have to wear a splint or cast?
- When is it safe to resume physical activities like sports?
Will a boxer's fracture heal on its own?
No, a boxer's fracture will never heal on its own. Any fracture should be properly examined and treated by a doctor. If you leave a boxer's fracture untreated, you are at a much higher risk of developing complications such as malunion.
A 'malunion' is when a broken bone fits together, but not in the correct position, in the correct alignment. It fits together. If that happens, you may have difficulty using your thumb later, and you may be more likely to break the same bone again in the future.
If you injure your arm and notice symptoms of a boxer's fracture, go to the emergency room immediately. Even if your bone is not broken, a doctor should definitely examine your injury.
Finally, a few things to remember
A boxer's fracture is a broken bone in your hand. It gets its name from how it usually happens – when you hit your hand with your fist against something hard. While this is a common injury during sports, it can also happen when you hit a wall or other hard object in anger.
It can be frustrating to miss weeks of training, competition, or other activities. But you can make a full recovery from a boxer's fracture. Don't ignore symptoms like pain and swelling in your hand, especially after an injury. See a doctor right away to get a diagnosis. The sooner your doctor diagnoses a boxer's fracture, the faster your broken metacarpal bone will start to heal.
` Boxer's fracture, hand fracture, metacarpal fracture, hand pain, hand swelling, sports injuries, bone treatment
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