During a tournament game the individual was intentionally checked while making a fast break. In response, the individual threw down his gloves and the two proceeded to fight. After the referees broke up the fight, the game continued on.

                After the game, the individual came to the ATC on staff complaining of pain and swelling of his right hand. Further evaluation showed pain with flexing and extending fingers and significantly decreased grip strength due to sharp pain. Individual proved point tender over the lateral aspect of the hand. Bump test and tuning fork was positive for reproduction of pain.

                The athlete was referred for x-rays on the following week. Imaging showed a transverse fracture at the neck of the fifth metacarpal. After discussion with the athlete, a conservative treatment approach was chosen and a hard cast was placed on the hand and wrist. The segment was immobilized for 3-4 weeks after which a protective splint would be worn for another 2-3 weeks. While in the hard cast the athlete continued to skate on the ice, ride the bike, and participate in team conditioning practices limited to core and lower body exercises. It is now week 4 and we can start the athlete on his wrist and hand rehabilitation program.