A boxer’s fracture of the hand is one of the more common hand injuries in young adults. This is a fracture of the fifth metacarpal neck right below the knuckle under the little finger, or pinky. In this Ask Dr. Geier video, I discuss these injuries and whether they can occur in different metacarpals and whether the treatment would change.

Cortney asks:
Does a boxer’s fracture have to be associated with the fifth metacarpal?

Usually orthopedic surgeons consider a boxer’s fracture to be a fracture of the fifth, or maybe the fourth, metacarpal neck. This is the part of the long bone on the outside of the hand just below the knuckle. If it’s the fourth metacarpal, it’s the same area, just one bone over. The mechanism of injury is usually still the same, punching a wall or another person.

It is possible to fracture the metacarpal neck of any of the five metacarpals, but technically they are not a boxer’s fracture. The treatment could be similar to a boxer’s fracture of the fifth metacarpal, below the pinky. But there is less room for angulation or improper alignment in this bone as compared to the fifth metacarpal. If there is any concern over what the next steps should be, consider seeing a hand surgeon for exam and x-rays to find out what the next steps are.

X-ray showing the location of a boxer's fracture

Also read:
When should you see a doctor for a boxer’s fracture?
What can cause a fracture to have delayed healing?

Please remember, while I appreciate your questions, I cannot and will not offer specific medical advice by email, on my website, on my podcast, or in social media. My responses are meant to provide general medical information and education. Please consult your physician or health care provider for your specific medical concerns.

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