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BOXER'S FRACTURE

A boxer’s fracture is a broken bone (fracture) in the hand near the knuckle of the fifth finger. This  injury usually occurs in professional fighters,  but it can occur in non-fighters when punching a hard object like a cement wall. With appropriate treatment and normal alignment of the bones, healing can be expected in about 4 to 6 weeks. Occasionally, surgery is necessary to re-align the bones of the hand.

Symptoms
Pain, tenderness, swelling (especially the back of the hand), and later bruising of the hand
Visible deformity if the fracture is complete
Loss of normal prominence of the knuckle at the little finger
Numbness from swelling in the hand, causing pressure on the nerves (uncommon)

Complications
Fracture does not heal (nonunion)
Fracture heals in a bad position, causing twisting of the finger when making a fist. (malunion)
Chronic pain, stiffness, or swelling of the hand
Arrest of normal hand growth in children
Shortening of injured bones
Bony prominence in palm or loss of contour of the knuckles
Persistent pain and weakness when gripping
Arthritic, unstable, or stiff finger joint if the fracture goes into the joint or after repeated injury or delayed treatment
Scarring around the knuckle and limited motion

Treatment
Because the part of the hand where a boxers fracture occurs has a lot of compensatory motion this fracture can heal with good function even if it heals without perfect alignment (position). If xrays reveal that the fractured bones are aligned within an acceptable range, the initial treatment consists of rest, ice, compressive bandage and elevation to reduce swelling and discomfort. Casting, splinting, or bracing may be recommended to provide support to the bone depending on severity and location of the injury. After immobilization, stretching and strengthening of the injured and weakened joint and surrounding muscles is often necessary. Surgical treatment is indicated if there is an unacceptable amount of bone angulation or non union of the bone fragments.