BOXER’S KNUCKLE

Boxer’s knuckle is characterized by pain and weakness over the knuckle of the hand due to injury of the tendons that straighten the joints of a finger. The extensor tendon attaches the forearm muscle to the bone that straightens the fingers. This injury involves a tear of the tendon or the tissues that hold the tendon in position. This problem most often occurs in the knuckle of the 2nd or 3rd fingers. Boxer’s knuckle is usually due to a direct blow or repeated blows to the knuckle, such as with boxing or martial arts. This results in a tear of the extensor tendon, the tissues that help hold the tendon in place, and occasionally injury to the tissue that surrounds the knuckle joint. This condition usually heals with splinting or surgery.

Complications include: an inability to straighten finger, finger stiffness, tendon rupture prolonged healing time, if usual activities are resumed too soon, and recurrence of symptoms and/or repeated injury.

Common Signs and Symptoms

Initial treatment involves splinting, icing and elevation to reduce swelling. Medications may be given for pain. If splinting is the treatment, this is for variable periods. Often, surgery is recommended to repair the injured tissues. After surgery, the joint is immobilized with a cast, brace, or splint to allow the tissues to heal. After immobilization (with or without surgery), stretching and strengthening of the injured and weakened joint and surrounding muscles (due to the injury and the immobilization) is necessary. This may be done with or without the assistance of an occupational or physical therapist or athletic trainer. Return to punching is allowed after full range of motion and normal strength are achieved, usually after 4 months.