If a boxer's fracture is detected, the primary goals of treatment are to immobilize the hand to permit proper healing and to alleviate the pain associated with fractures.
In order to properly immobilize most broken bones, the splint should immobilize the joints above and below the site of injury. In the case of a boxer's fracture, different types of splints may be used. One type of splint may extend from the fingers, with the fingertips exposed, to the forearm near the elbow. Another type of splint that has been shown to be effective for some boxer's fractures of the little finger is to buddy-tape the ring finger and little finger together. Your doctor will decide what type of splint will treat your fracture the best.
- When a boxer's fracture occurs, it is possible for a portion of the metacarpal bone to move out of normal alignment. This is called angulation. The amount of angulation will determine what type of treatment is required to ensure proper healing. People with boxer's fractures who have acceptable amounts of angulation may be splinted in the emergency department or doctor's office.
- Any degree of angulation in the second or third metacarpal bones is considered abnormal and requires referral to a hand specialist for possible surgical repair. Boxer's fractures of the fourth and fifth metacarpal bones only require surgery if large degrees of angulation are present and the bones cannot be moved into the correct place by pulling and pushing on them.
- Because broken bones can cause significant amounts of pain, pain management is an important aspect to treating broken bones. Pain management is best accomplished with anti-inflammatory medicines and pain relievers. Acetaminophen (Tylenol) or ibuprofen (Advil) usually provides good pain relief with few side effects. These over-the-counter medications, or any prescription pain medicines, should be taken as directed to decrease the risk of side effects.
Next Steps Follow-up
A person with a boxer's fracture frequently is advised to follow-up with a bone specialist (orthopedic surgeon) or a hand specialist to ensure that the broken bone mends properly. The hand specialist may be either an orthopedic surgeon or a plastic surgeon who specializes in hand injuries.
- Follow-up should occur within 1 week of the initial injury if there is not a critical amount of angulation. If angulation of the fracture exceeds acceptable levels, follow-up should occur sooner.
- If a plaster splint is placed in your doctor's office, or in the emergency department, and you develop increased pain or numbness in your fingers, or if your fingers become cold and blue, then loosen the splint, notify your doctor, and return to the emergency department immediately.
The key to preventing boxer's fractures is to avoid situations in which the injury can occur. Boxer's fractures most commonly occur during fist fights and when someone punches a hard object in anger or frustration. Avoiding these situations can reduce significantly the risk of sustaining a boxer's fracture. In addition, decreasing the loss of bone that occurs naturally with age also is critical. This can be accomplished with regular exercise and calcium supplements or adequate intake of dairy products.