![]() Impacted Boxer’s Fracture Requiring Fixation Open reduction and internal fixation using Kirshner wires, and a dorsal stainless steel loop can also be used in severe fractures.Most frequently used is a dorsal plaster slab and finger extensor.Closed reduction and external fixation with a brace or functional tapping, can sometimes align fracture ends sufficiently.Discussion of the case with local hand or orthopaedic surgeon, will develop treatment plan and follow up, and will generally guide further management. Immobilisation, functional treatment/minimal immobilisation can all be used with similar result. Severe fractures occur if angulation is greater than 45° or if rotation is greater than 20° external reduction is required.Ĭurrently there is no consensus on the correct management of boxer’s fracture.Open fractures require antibiotics, refer to local guidelines.X-ray: AP and Oblique view should be obtained lateral views can help with assessing angulation and other injuries in the carpometacarpal area.Simple Analgesia= Paracetamol-codeine, NSAIDs.Rest, Ice, Sling for support, Elevation.If injury occurred during a fight, look for other injuries as well.Ĭlinical appearance of Right Boxers fracture Emergency management of boxer’s fractures.A high clinical suspicion should be used when assessing these injuries. The patient may be reluctant to disclose the mechanism of injury related embarrassment, or fear or repercussions if they disclose it occurred in a fight.The typical symptoms of a boxer’s fracture are pain or tenderness centered in a specific location on the hand corresponding to one of the metacarpal bones, around the knuckle.One of the most common injuries seen in the ED, and occurs in 20% of patients that punch a hard object.A fracture of the forth or fifth metacarpal neck with volar displacement of the metacarpal head.AKA = Intellectually Destitute Fracture.Boxer’s Fracture (5th Metacarpal neck fracture): ![]()
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