Wednesday, January 12, 2011

Boxer's fracture (distal tip fracture on the fifth metacarpal)

It’s the fracture that occurs at the neck of the bones which form the knuckles of the hand. It almost always occurs as a result of an impact of a clenched fist to a hard object.

In the suspected cases, it’s useful to apply some ice and to raise the arm above the heart until the patient has arrived at the doctor’s. It is diagnosed with the pain, swelling after the trauma and with the determination of the fracture on direct radiography (figure 1).


The treatment is to realign the fracture by hand and to apply hard casts. However, in some cases the fracture has multiple parts and cannot be realigned by hand (or can’t keep its position after realignment). In these cases, the multiple fracture parts may need to be splinted using strings. (figure 2,3)

Open or closed technique is chosen according to the position of the fracture. Operation is performed using axillaries or ulnar nerve complex. The patient doesn’t need to be under anaesthesia completely and discharged from hospital on the same day. If the fracture is recovered following 4-6 weeks, the hard casts and strings then can be removed. A physiotherapy counselling or support is very useful following this period.

Source: Boxer's fracture



2 comments:

  1. I have a question regarding closed reduction methods of the boxer's fracture - the doctor I was given articulated the 5th metacarpal break through downward force on the back of the hand and upward pressure on the ball of the palm - but it's still far from correct,
    leaving me rather dissatisfied with the result I researched this method and see that the best manner of correction is to force the flexed pinkie upward to achieve near perfect results, why wasn't this approach the "jahss maneuverer" done?
    and is ittoo late to attempt this in the 4th week without rebreaking the fracture site?

    My hands are very important for the line of work I do and a second opinion would be greatly appreciated

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  2. answer
    you are right hand are very important in our lifes. Four weeks too late to attempt colesed reduction that is why dont think the maneuverer mecanism .you need profesionel support

    ReplyDelete