A boxer’s fracture is when you break a bone at the base of your finger, near the knuckle or neck of the bone. That bone is known as a metacarpal.

A boxer’s fracture may also be called fifth metacarpal fracture. It usually happens to the small (pinky) finger or the ring finger and is most common in men.

The symptoms of a boxer’s fracture may include:

  • pain
  • painful bruising
  • swelling of both sides of the hand that happens quickly
  • tenderness near the base of the pinky finger
  • inability or limited ability to move the pinky or ring finger
  • the knuckle of the affected finger appearing flat and no longer protruding as usual
  • problems trying to grip with the injured hand
  • numbness
  • coldness in the hand

The main cause of the injury is also how it gets its name. It’s most often caused by a boxer hitting their fist on a human face or other hard object. However, it can happen to anyone who hits a hard object with a closed fist. It can also happen if you hit your flat hand very hard against a hard object.

Your doctor will evaluate your injury. As part of the evaluation, they’ll ask you how the injury occurred. You’ll most likely need an X-ray to determine if the bone is broken and if it’s broken in the neck of the fifth metacarpal. The doctor will need to make sure it isn’t another bone that’s broken or in a different spot. This extra care in diagnosis is needed because treatment differs for different types of broken bones.

The treatment options for a boxer’s fracture depend on the severity of your injury.

Some treatments that may be used include:

  • applying ice to the hand
  • using a splint to hold it stable while it heals
  • not using your hand for a period of time
  • keeping your hand above heart level
  • taking prescription or over-the-counter pain medication, depending on the amount of pain
  • cleaning and treating any wounds on the skin of the injured hand
  • taping the hand as a type of soft splint, with the pinky and ring finger taped together to help in healing
  • correction of the dislocated bone, which may be done with anesthesia
  • physical therapy if needed to regain full use of your hand
  • home exercises to regain strength and use of your hand

Your treatment may also include surgery if the break is severe enough, if the broken bone protrudes from the skin, or if there are multiple fractures. Surgery is also used for people who use their hands for minute motor skills, such as playing the piano.

Recovery time varies based on the severity of the boxer’s fracture and the extent of treatment that was needed. If it was a simple fracture and you follow your doctor’s treatment plan, then your recovery may only last two to three weeks. However, if surgery or physical therapy is required, then your recovery time may increase to four to six weeks or possibly longer.

The following are some do’s and don’ts for recovery and aftercare:

Do’s

  • See the doctor if you have symptoms of boxer’s fracture.
  • Follow your doctor’s treatment plan.
  • Keep your splint on for the designated amount of time.
  • Go to all your physical therapy appointments if physical therapy is needed.
  • Do your at-home exercises daily.
  • Protect your injured hand while it heals.
  • Eat healthy and include plenty of foods with protein, calcium, and vitamin D.

Don’ts

  • Don’t assume it will get better on its own.
  • Don’t wait to see a medical professional.
  • Don’t try to treat it yourself.
  • Don’t use your injured hand until your doctor says it’s safe.
  • Don’t get your splint wet.
  • Don’t smoke. Your fracture will heal faster.
  • Don’t get into a fist fight.

If you get your boxer’s fracture treated promptly and follow your treatment plan, there are normally no long-term effects. Usually, if there are long-term effects, they are minor and don’t interfere with your daily life.

The complications of a boxer’s injury are usually minor and occur primarily when the injury is left untreated. Some complications may include:

  • inability to grip or hold things in that hand
  • a permanently crooked finger
  • decreased range of motion in the injured finger

If treated and managed properly, a boxer’s fracture will heal completely with few to no complications. It’s important that you go to a doctor or medical professional as soon as possible after the injury occurs to ensure the best possible outcome.