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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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If a boxer's fracture is detected, the primary goals of treatment are to immobilize the hand to permit proper healing and to alleviate the pain associated with fractures.

In order to properly immobilize most broken bones, the splint should immobilize the joints above and below the site of injury. In the case of a boxer's fracture, different types of splints may be used. One type of splint may extend from the fingers, with the fingertips exposed, to the forearm near the elbow. Another type of splint that has been shown to be effective for some boxer's fractures of the little finger is to buddy-tape the ring finger and little finger together. The doctor will decide what type of splint will treat the patient's fracture the best.

• When a boxer's fracture occurs, it is possible for a portion of the metacarpal bone to move out of normal alignment. This is called angulation. The amount of angulation will determine what type of treatment is required to ensure proper healing. People with boxer's fractures who have acceptable amounts of angulation may be splinted in the emergency department or doctor's office.
• Any degree of angulation in the second or third metacarpal bones is considered abnormal and requires referral to a hand specialist for possible surgical repair. Boxer's fractures of the fourth and fifth metacarpal bones only require surgery if large degrees of angulation are present and the bones cannot be moved into the correct place by pulling and pushing on them.
• Because broken bones can cause significant amounts of pain, pain management is an important aspect to treating broken bones. Pain management is best accomplished with anti-inflammatory medicines and pain relievers. Acetaminophen (Tylenol) or ibuprofen (Advil) usually provides good pain relief with few side effects. These over-the-counter medications, or any prescription pain medicines, should be taken as directed to decrease the risk of side effects.

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