Boxer’s Fracture

Named after a sport implicated in causing its fair share of hand fractures, a boxer’s fracture involves a break in the neck of the fifth metacarpal bone. This was described originally as such, because the metacarpal bone of the little/pinky finger is the most common one to break when punching an immovable object.

The metacarpal bones connect the bones of the fingers (the phalanges) to the bones of the wrist (the carpals). The neck of the metacarpal bone is where the bone begins to widen out towards the knuckle.

While this type of fracture often occurs when a clenched fist hits a hard object, such as in a fight or when punching a wall, it has also been seen as a result of a hard fall.

Some common symptoms of a boxer’s fracture include:

  • Painful bruising and swelling
  • Tenderness near the fractured fifth metacarpal
  • Slight deformity of the pinky finger
  • Limited grip strength and range of motion

X-ray of a displaced boxer’s fracture in a 20- year-old male, who fell off of a motorized scooter.

X-ray of the displaced boxer’s fracture surgically repaired with pins.

A physical examination followed by an x-ray will confirm the diagnosis of a boxer’s fracture. While some fractures of this type may require a period of specialized casting or splinting only, displaced and more severe fractures may require surgical repair.

Failure to properly treat a boxer’s fracture could lead to permanent deformity, reduction in grip strength and range of motion, and loss of fine motor-movement of the hand. This could also lead to the early onset of osteoarthritis.

Injuries & Conditions