Boxer's Fracture (cont.)
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Boxer's Fracture Diagnosis
Physical examination in conjunction with X-rays is essential to properly diagnose a boxer's fracture. Findings that suggest the need for X-rays include activities that increase the risk of fracture, deformity of the hand, localized tenderness, swelling of the hand, discoloration, decreased ability to move the hand, wrist or fingers, numbness, unequal temperatures between the injured and uninjured hands, or a cut caused by teeth when punching someone in the mouth (resulting in a human bite injury).
The doctor will determine if X-rays are warranted based on the circumstances surrounding the injury. After the doctor obtains detailed information about how the hand was injured, a physical examination is the next step in the evaluation.
X-rays of the hand are performed to look at the hand from three different directions. Evaluating the hand from different viewpoints reduces the risk of not seeing a fracture on the X-ray. After evaluating the bones on the X-ray, the doctor can determine what type of fracture is present. In certain cases, the doctor may order more X-rays, with special views to look for hard-to-find fractures. These studies are ordered when the standard X-rays do not show a fracture and the information regarding the patient's injury or physical examination suggests the presence of a hard-to-find fracture.
On physical examination the doctor will look for the presence of foreign bodies in the hand. Activities that could cause a foreign body to become lodged in the hand include:
punching another person in the mouth
Foreign bodies that may show up on X-rays are glass, bone, metal, and stones. However, organic or living materials such as wood or plants will not show up on standard X-rays and will require further studies if their presence is suspected.
Manuel Hernandez, MD
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