When to Seek Medical Care
Any time you have an injury and a fracture is suspected, contact your doctor for instructions. If the doctor is unavailable, go to the emergency department for evaluation. Also contact your doctor or go to the emergency department if you have been splinted or casted and develop increasing pain, numbness, or tingling in the fingers on the casted arm. Any signs of infection from a cut or stitched wound also require evaluation by a doctor.
Any hand injury that has signs or symptoms suggesting a fracture should be evaluated by a doctor. This may be accomplished by contacting your doctor. If your doctor can't see you right away, you may go to a hospital's emergency department.
Exams and Tests
Physical examination in conjunction with x-rays is essential to properly diagnose a boxer's fracture. Findings that suggest the need for x-rays include activities that increase the risk of fracture, deformity of the hand, localized tenderness, swelling of the hand, discoloration, decreased ability to move the hand, wrist or fingers, numbness, unequal temperatures between the injured and uninjured hands, or a cut caused by teeth when punching someone in the mouth (resulting in a human bite injury).
- The doctor will determine if x-rays are warranted based on the circumstances surrounding the injury. After the doctor obtains detailed information about how the hand was injured, a physical examination is the next step in the evaluation.
- Swelling and discoloration commonly are seen with fractures and are associated with damage caused by direct trauma to the bone and surrounding muscles, ligaments, tendons, nerves, and blood vessels.
- Decreased ability to move the hand in the usual directions and manner may result from the swelling or pain associated with the fracture. The doctor will ask you to make a fist. This helps to determine the extent of the injury, as well as the type of treatment that may be needed. This also may indicate if a ligament has been torn. Torn ligaments will not show up on standard x-rays, but they sometimes occur with fractures.
- X-rays of the hand are performed to look at the hand from 3 different directions. Evaluating the hand from different viewpoints reduces the risk of not seeing a fracture on the x-ray. After evaluating the bones on the x-ray, the doctor can determine what type of fracture is present. In certain cases, the doctor may order more x-rays, with special views to look for hard-to-find fractures. These studies are ordered when the standard x-rays do not show a fracture and the information regarding your injury or physical examination suggests the presence of a hard-to-find fracture.
- On physical examination the doctor will look for the presence of foreign bodies in the hand. Activities that could cause a foreign body to become lodged in the hand are these: punching another person in the mouth, being bitten by an animal, being cut with a sharp object, a penetrating injury, or abrasions or splinters from an object. Foreign bodies that may show up on x-rays are glass, bone, metal, and stones. However, organic or living materials such as wood or plants will not show up on standard x-rays and will require further studies if their presence is suspected.