Dr Priscilla D’Agostino

Brussels Hand Surgery

LOUISE +32 2 534 29 99 Fax +32 2 534 53 22

Boxer’s fracture

QT Pathologies (EN)

A Boxer's fracture is most commonly a break of the neck of the fourth or fifth metacarpals, just below the head of the metacarpal.

  • Fracture of the neck of the fifth metacarpal (boxer fracture) Fracture of the neck of the fifth metacarpal (boxer fracture)

A Boxer's fracture is caused by the impact of a clenched fist against a very hard surface (such as a human skeleton or a wall).

An improper punch is often the cause of the break.

Pain, swelling and loss of hand function are usual symptoms.

The prominence loss of the knuckle of the affected finger (MCP joint) is a typical feature of this injury.

Boxer's fracture is diagnosed on the basis of X-rays. The severity of the fracture and the angle in between both pieces of bone will be analyzed.

Non-surgical

Boxer's fracture may be treated non-surgically by placing the hand in a splint or cast in flexion of the metacarpophalangeal joint (MCP).

Before splinting, a closed reduction under local anesthesia using a specific maneuvre (Jahss maneuver) can be done to obtain a good alignement of bones so that they will heal together properly.

Surgical

Beyond 70 degrees of displacement (the angle in between both broken bones) or if the fracture is unstable after reduction, surgery is necessary to stabilize the fracture.

Depending of the type of fracture, surgical fixation may be achieved by pins or plates and screws.

During your consultation, Dr. D'Agostino will discuss the current treatment options and can help you choose the best treatment based on your particular case.

  • Fifth metacarpal neck fracture stabilization by intramedullary pinning Fifth metacarpal neck fracture stabilization by intramedullary pinning