What is a Boxer’s fracture?? Fracture of the 4th or 5th metacarpal neck - Common in younger males - Usually secondary to the following injuries: punching a wall, direct blunt/force trauma, falls onto the hand Symptoms/exam findings concerning for Boxer’s fracture? - Pain along ulnar aspect of the hand - Swelling along dorsum or ulnar part of hand - Focal tenderness or step off over fractured metacarpal - Always check for skin integrity, intact strength/sensation, and pulses!! - Don’t miss – compartment syndrome! Management: - Immobilize with ulnar gutter splint – usually for 4 weeks Urgent orthopedics referral: - Neurovascular compromise - Certain radiologic findings: - Comminuted - Displaced or evidence of malrotation - Compromise of growth plate or articular space - Multiple fractures - Overlying wounds or signs of open fracture Hand consult recommended if injury of dominant hand or occupation/hobbies significantly affected! #Boxers #Fracture #Hand #Metacarpal #Diagnosis #Management #Referral #Orthopedics
