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.
Home care for boxer's fractures can be divided into care prior to seeing a doctor, and care after a diagnosis of a boxer's fracture is made.
The immediate goals of caring for an injured hand are to minimize pain and swelling, minimize the risk of infection of any open cuts, and to prevent further injury caused by an unstable fracture.
The best approach to reduce pain and swelling is to
apply an ice pack to the injured area. If ice is not available, placing a
towel soaked in cold water on the injured hand will work. Elevating the injured hand will also help reduce swelling.
An open cut sustained at the time of injury suggests an open fracture - a type of broken bone that is at increased risk for infection and poor healing. All cuts should be washed with soap and water and then covered with a clean bandage immediately to reduce the risk of infection.
A key technique to prevent further injury from a fracture is to immobilize the injured hand. This is often best accomplished by holding the injured hand in the uninjured hand. In addition, take care not to use the injured hand to lift objects or perform any task that would place
stress on it. Using a
broken hand that is not properly immobilized can cause damage to surrounding muscles, blood vessels, tendons, ligaments, and nerves.
Home care after the diagnosis of boxer's fracture is based on how the doctor treated the hand. Home care includes pain management, cast or splint care, and monitoring for signs of infection.
Bones, like many other parts of the body, contain nerve fibers that transmit the sensation of pain. Pain from broken bones is caused by swelling due to injury of the tissues around the fracture site, or by the broken bone moving against the nerve fibers. Pain should lessen once a broken bone is immobilized and movement is prevented. Some degree of pain may still persist. When a doctor writes a prescription for
pain medication, it is important to take the medication as prescribed. This
will help alleviate pain and will minimize the risk of any unwanted side
effects from the medication. For mild pain, over-the-counter
ibuprofen (Advil) may be used as directed on the label. This should be discussed with the doctor before
taking these medicines.
Splinting or casting commonly is performed on all boxer's fractures that do not require immediate surgery. All splints and casts should be kept dry in order to maintain their strength. A complication that can be seen with this procedure is the cast becoming too tight from the swelling of the fracture. When this happens,
the patient may feel pain under the cast or splint. Another sign is numbness or tingling in the fingers on the casted hand. In addition, the finger may become cool to the touch. When this occurs, call
the doctor or go to a hospital's emergency department immediately for evaluation.
Infection can occur at an open cut.
Wounds should be kept clean and covered until healing is complete. If stitches are used to close a cut, the doctor will provide additional instructions on how to care for the stitches and when they should be removed. It is important to follow these directions carefully to minimize the risk of infection. Monitor any cuts for signs of infection. Warning signs of infection include redness, red streaking away from the cut, warmth, or swelling around the site of the cut. Pus may also drain from the wound. Any of these signs requires immediate