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Typically, a boxer’s fracture is a break in one of the bones in the hand, namely the fourth or fifth metacarpal. These bones run along the pinky and ring finger side of your hand from your wrist to the base of your fingers.

Every once in a while, a break in the first or second metacarpal will be classified as a boxer’s fracture. Some individuals also call a boxer’s fracture, a brawler’s fracture.

Causes Of Boxer Fractures

The main cause of a boxer’s fracture is by a severe blow to the hand which most of the time happens when you are punching something with a closed fist, hence the name boxer’s fracture.

A boxer’s fracture may also happen after what is known as a FOOSH injury, which is trauma that may happen in a fall on an outstretched hand.

Symptoms Of A Boxers Fracture

The main symptoms of a boxer’s fracture include:

  • Pain in your hand near the pinky or ring finger
  • Swelling in the lateral part of your hand
  • Decreased motion in your pinky, ring finger or wrist
  • Discoloration or bruising in your hand
  • Displacement of one of your knuckles in the hand

Typically these symptoms happen after trauma to the hand. If you have pain in the hand and think you have suffered a boxer’s fracture, our Palmdale Physical Therapist suggest you seek out medical attention right away.

Your doctor or local emergency department can properly help with reducing the fracture for you. If you do not seek medical attention, it can lead to permanent loss of function in the hand or fingers.

Initial Treatment

The diagnosis of a boxer’s fracture is done with an x-ray. The bones of your hand can be visualized, and the break in your metacarpal can be quite notable.

If a separation happens to occur of the bone near the fracture site, a manual reset may be needed. In rare but drastic cases, a surgical procedure may be necessary to aid in stabilizing the fracture.

Surgery generally involves using pins that pass through the skin and into the bones to hold the bones in place while the healing happens.

After the fracture is reset, you may be cast or immobilized with a splint to ensure proper healing occurs. Research published in 2016 found that outcomes were the same when a boxer’s fracture was treated with sprinting versus soft wrapping of the wrist and hand. The authors concluded that casting and splinting may not be necessary to treat a boxer’s fracture.

Our Palmdale Physical Therapist suggest you make sure to follow the directions your doctor provides you in regard to splinting and casting.

Physical Therapy For A Boxers Fracture

After four to six weeks in the cast or splint, adequate healing should have occurred so that you may start physical therapy to rehabilitate your injury.

The initial focus of physical therapy is to counteract the effects of being immobilized while the fracture healed.2 Some impairments that you may experience include:

  • Loss of range of motion
  • Loss of strength
  • Swelling
  • Pain

All of these impairments can lead to loss of normal function in your hand and wrist. You may have difficulty gripping items or managing fine motor tasks such as writing.

Physical Therapy Treatments For Boxer Fractures

Your local Palmdale Physical Therapy program after a boxer’s fracture may include many different treatments and modalities. 

Electrical stimulation may be used to treat pain and swelling. Massage and​ soft tissue techniques may help to improve the mobility of the skin, muscles, and tendons around the wrist and hand.

Our Palmdale Physical Therapist say that exercise should be the main component of your physical therapy program following a boxer’s fracture. Exercises to improve grip strength and finger strength are important to help improve hand function.

The range of motion exercises for the wrist and fingers should be incorporated. Strengthening exercises should focus on the muscles of the forearm, arm, and hand. 

Your fracture should be healed and typical function should be restored about 10 to 12 weeks after the initial injury.

Your specific rate of healing may vary depending on just how drastic the injury and your current health status is.

Our Palmdale Physical Therapist suggest you make sure you speak with your physical therapist and doctor to clearly understand how your specific condition is expected to get better.