What is a boxer’s fracture?

Figure 1: Hand Pain - Boxers Fracture - Physio Frenchs Forest, Physio Macquarie Park

A metacarpal fracture is a break in the hand. It's an extremely common injury that occurs when the hand is twisted or if you punch something hard. The metacarpal is the bone that connects your fingers to your wrist. They connect to the phalanges at either end and allow for bending and straightening of your fingers. A metacarpal fracture can be stable or unstable, depending on whether there's displacement between the broken ends of bone as they heal over time

A boxer's fracture is a fracture specifically to the 5th metacarpal. This is because it's such a common injury among boxers.

There are two types of boxer's fractures:

One type is stable, and the other is unstable.

The more common type of boxer's fracture is called an "unstable" boxer's fracture, which means that the broken ends of bone have moved out of alignment and need to be put back in place with surgery. This can result in serious pain and discomfort for patients who suffer from this injury—and it also carries higher risk factors for long-term complications like arthritis, poor grip strength or poor range of motion.

With a stable fracture the bones are not displaced and don't need to be put back in place. A stable fracture is not displaced and doesn't need to be put back in place. This type of fracture usually heals on its own without surgery. The doctor may recommend wearing a splint for 4-6 weeks.

Figure 2: Hand Pain - Boxers Fracture - Physio Frenchs Forest, Physio Macquarie Park

With either type of fracture, you need an X-ray to diagnose and assess the extent of your injury.

An X-ray is the best way to diagnose a metacarpal fracture. It can show whether there are any broken bones and how far apart they might be. The X-ray will also tell your doctor whether the bones are stable or not, and if there is any displacement of the bones. This information helps determine what type of treatment you need right away, so it’s important to have an X-ray as soon as possible after you sustain this injury. Additionally, the Physiotherapist or Doctor will assess how much rotational deformity is present. This is assessed by asking the patient to make a fist. If the finger curls across/scissors, then a surgical intervention is recommended (see image 2 for scissoring looks like).

How long should you avoid sport?

The patient should avoid strong gripping and sporting activities for 10-12 weeks from the injury.  

See our expert Physiotherapy team at Frenchs Forest and Macquarie Park!