(Fifth Metacarpal Fracture)
by Deanna M. Neff, MPH
Boxer's fracture is a common name for a fracture of the long bone that connects the little finger to the wrist.
The types of boxer's fractures are:
Fractures may either be:
Boxer's fracture can be caused by:
Risk Factors TOP
Boxer's fractures are more common in men. Other factors that may increase your risk of a boxer's fracture include:
A boxer's fracture may cause:
You will be asked about your symptoms and medical history. A physical exam will be done. The injured finger will be examined.
Images may be taken of your hand. This can be done with x-rays.
Proper treatment can prevent long-term complications or problems with the finger or hand. Treatment will depend on how serious the fracture is, but may include:
Extra support may be needed to protect, support, and keep the finger in proper position while it heals. Supportive steps may include a splint, brace, or cast.
Some fractures cause pieces of bone to separate. These pieces will need to be put back into their proper place. This may be done:
Wound care is an important part of recovery. This is especially true if there was a break in the skin.
Children’s bones are still growing at an area of the bone called the growth plate. If the fracture affected the growth plate, a specialist may be needed. Injuries to the growth plate will need to be monitored to make sure the bone can continue to grow as expected.
Over-the-counter or prescription pain medication may be given to reduce discomfort. Antibiotics may also be given if an infection is present or possible.
Depending on your vaccination history, you may need a tetanus or other shots.
Rest and Recovery TOP
Healing time varies by age and overall health. Children and people in better overall health heal faster. In general, it takes up to 6 weeks for a boxer's fracture to heal.
Activities will need to be adjusted while the finger heals, but complete rest is rarely needed. Ice and elevating the hand at rest may also be advised to help with discomfort and swelling.
A physical therapist or rehabilitation program may be advised to start range-of-motion and strengthening exercises.
To help reduce your chance of boxer's fracture:
To help reduce falling hazards at work and home:
American Orthopaedic Society for Sports Medicine
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
When it Hurts to Move—Canadian Orthopaedic Foundation
Gudmundsen TE, Borgen L. Fractures of the fifth metacarpal. Acta Radiol. 2009;50(3):296-300.
Metacarpal neck fracture—emergency management. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Accessed August 24, 2017.
Hand fractures. American Academy of Orthopedic Surgeons Ortho Info website. Available at:
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Updated October 2007. Accessed August 24, 2017.
Poolman RW, Goslings JC, et al. Conservative treatment for closed fifth (small finger) metacarpal neck fractures. Cochrane Database Syst Rev. 2005;(3):CD003210.
Last reviewed September 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 9/5/2014
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