Do I have a boxer's fracture?
Q: I am a 19 years old girl who got hit on the knuckle with a toy car 2 days back. At first, it hurt a little but now it seems to be paining all the time. I tried putting ice on it and wrapping it in cloth but it hurt even more. My hand is bruised and swollen around the knuckle and seems to be a little discoloured too. I can bend my fingers but it hurts whenever I do it. Do I have a boxer's fracture?
A:Metacarpal neck fractures (Boxers fracture) are common and usually involve the ring and small fingers. Boxer’s fracture is really a misnomer. Fractures of the fifth metacarpal neck are rarely seen in professional boxers; they are far more common in brawlers and in people who hit solid objects (in your case). The involvement of the finger depends upon the area of contact. It is index (second metacarpal neck) finger in your case. I would like you to check yourself the following simple tests to detect the fracture pattern:
- Place the palm on the table looking your face; then try bending all your fingers. Look for any scissoring or overlapping of your fingers (especially index and middle fingers). If you don't have then, it means there is no rotation of the fracture of 2nd metacarpal.
- If the knuckle is depressed compared to the other fingers, it means there is angulation. It is expected in this fracture.
- Those with functional brace have faster return to work.
- No significant disability with up to 70 degree of angulation.
- No relationship between the presence of symptoms and angulation.
- There will be a detectable loss of knuckle prominence which wont affect the normal daily activities.