Boxer's (or Brawler's) Fracture

• Fifth metacarpal neck fracture, usually secondary to a direct blow or closed-fist impact.
• Potentially an unstable fracture and difficult to maintain reduction due to tension from tendons and muscles in the hand.
• Up to forty degrees of angulation can be tolerated without repair, although there is potential for reduced hand function without repair. Any rotational deformity, however, must be corrected.
• Non-displaced fractures: RICE therapy, gutter splint, and Ortho follow-up.
• Displaced, rotated, or angulated fractures (>40 degrees): closed reduction may be attempted but surgical fixation usually required.

References

Many thanks to Dr. George Kochman for submitting this case!