• Boxer’s Fracture

    (Fifth Metacarpal Fracture)


    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:
    • Nondisplaced—the bone is broken, but remains in place
    • Displaced—ends of the bone are separated from one another
    • Comminuted—the bone is broken into several pieces
    Fractures may either be:
    • Closed—the fracture does not break the skin
    • Open—the fracture breaks through the skin
    Bones in the Hand
    Bones in the Hand
    Copyright © Nucleus Medical Media, Inc.


    Boxer's fracture can be caused by:
    • Punching another person or object, such as a wall, with a closed fist
    • Falls
    • Playing certain sports
    • Squeezing or crushing of the hand

    Risk Factors

    Boxer's fractures are more common in men. Other factors that may increase your risk of a boxer's fracture include:
    • Being prone to angry outbursts or fighting
    • Participating in certain sports, such as boxing or football
    • Increased age
    • Osteoporosis
    • Certain diseases or conditions that result in bone or mineral loss, such as abnormal or absent menstrual cycles, or post- menopause
    • Certain diseases and conditions that weaken bones, such as tumors or cysts
    • Decreased muscle mass
    • Exposure to violence


    A boxer's fracture may cause:
    • Swelling
    • Pain
    • Deformity
    • Lack of movement
    • Depressed knuckle


    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 your finger or hand. Treatment will depend on how serious the fracture is, but may include:

    Initial Care

    Extra support may be needed to protect, support, and keep your 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:
    • Without surgery—you will have anesthesia to decrease pain while the pieces are moved back into place
    • With surgery—pins, screws, or plates may be needed to reconnect the pieces and hold them in place
    Wound care is an important part of your recovery. This is especially true if you punched a wall, or someone in the mouth, which resulted in 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, your child may need to see a specialist. Injuries to the growth plate will need to be monitored to make sure the bone can continue to grow as expected.


    Your doctor may advise:
    • Over-the-counter pain relievers, such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs)
    • Prescription pain relievers
    • Antibiotics if an infection is present or possible
    Check with your doctor before taking nonsteroidal anti-inflammatory medications, such as ibuprofen or aspirin.
    Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.
    Depending on your vaccination history, you may need a tetanus or other shots.

    Rest and Recovery

    Healing time varies by age and your 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.
    You will need to adjust your activities while your 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.
    As you recover, you may be referred to physical therapy or rehabilitation to start range-of-motion and strengthening exercises. Do not return to activities or sports until your doctor gives you permission to do so.


    To help reduce your chance of boxer's fracture, take these steps:
    • Do not put yourself at risk for trauma.
    • Avoid situations where fights may occur.
    • Consider anger management if you have repeated anger outbursts or are prone to fighting.
    • Wear proper padding and safety equipment when participating in sports or activities.
    To help reduce falling hazards at work and home, take these steps:
    • Clean spills and slippery areas right away.
    • Remove tripping hazards such as loose cords, rugs, and clutter.
    • Use non-slip mats in the bathtub and shower.
    • Install grab bars next to the toilet and in the shower or tub.
    • Put in handrails on both sides of stairways.
    • Walk only in well-lit rooms, stairs, and halls.
    • Keep flashlights on hand in case of a power outage.


    American Academy of Orthopaedic Surgeons http://www.orthoinfo.org

    American Orthopaedic Society for Sports Medicine http://www.sportsmed.org


    Canadian Orthopaedic Association http://www.coa-aco.org

    Canadian Orthopaedic Foundation http://www.canorth.org


    Gudmundsen TE, Borgen L. Fractures of the fifth metacarpal. Acta Radiol. 2009;50(3):296-300.

    Hand and wrist pain—differential diagnosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 14, 2014. Accessed September 5, 2014.

    Hand fractures. American Academy of Orthopedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00010. Updated October 2007. Accessed August 5, 2015.

    Poolman RW, Goslings JC, et al. Conservative treatment for closed fifth (small finger) metacarpal neck fractures. Cochrane Database Syst Rev. 2005;(3):CD003210.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.