Boxer's Fracture

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Medical Author:

Manuel Hernandez, MD

Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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• Boxer's Fracture Overview
• Boxer's Fracture Causes
• Boxer's Fracture Symptoms
• When to Seek Medical Care
• Boxer's Fracture Diagnosis
• Boxer's Fracture Treatment
• Boxer's Fracture Self-Care at Home
• Boxer's Fracture Medical Treatment
• Boxer's Fracture Follow-up
• Boxer's Fracture Prevention
• Boxer's Fracture Prognosis
• Synonyms and Keywords
• Author and Editor
• Viewer Comments: Boxer's Fracture - Symptoms

A boxer's fracture is a break through the bones of the hand that form the knuckles. Some doctors use the term "brawler's fracture" rather than "boxer's fracture" because a boxer is not likely to get this injury. The less well-trained brawlers have to learn how to punch without hurting themselves.

The metacarpal bones in the hand connect the bones in the finger to the bones in the wrist. There are five metacarpal bones, one to connect each finger to the wrist. All of the metacarpal bones have the same anatomic structure. Each consists of the base, the shaft, the neck, and the head.

• The base of the metacarpal bone is the portion that attaches to the bones of the wrist.
• The shaft is the long, slender portion of the bone.
• The neck is the portion of the bone that connects the shaft to the head. The head of the metacarpal bone connects the metacarpal bone to the bone of the finger.
• The head of the metacarpal bones form the knuckle of an enclosed fist.
• A boxer's fracture involves a break in the neck of the metacarpal. This was described originally in the fracture of the metacarpal bone of the little (small) finger because this is the most common one to break when punching an immovable object.

Boxer's fractures occur in the metacarpal bones that connect the ring finger or the little finger to the wrist. These are known as the fourth and fifth metacarpal bones. Some doctors include breaks in the neck of the second and third metacarpal bones in the definition of a boxer's fracture. The second metacarpal bone connects the index finger to the wrist, and the third metacarpal connects the middle finger to the wrist.

Boxer's fractures received their name from one of their most common causes-punching an object with a closed fist. This occurs commonly during fist fights or from punching a hard object such as a wall or filing cabinet. Although these breaks usually occur when the hand is closed into a fist, they can also occur when the hand is not clenched and strikes a hard object.

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