"Do I Need SURGERY?"

Treatment Options 

• Immobilization

  • If the reduction allows satisfactory alignment, closed reduction and external fixation with a brace or hard cast is typically the way to go. Some patients may require an analgesia in order to reduce the displaced fracture

• Minimal Immobilization

  • Treatment of this type of fracture depends on the degree of angulation and rotation of the metacarpal head. If the angle is less than 40° with little or no rotation and slight displacement, strapping or a light plaster cast can be used to simulate minimal immobilization. The light plaster cast may provide a greater sense of security, but recovery time is often longer than that taken by the fracture that was treated by strapping the little finger to the ring finger.

• Most Severe Fracture Type

  • A boxer's fracture is considered most severe if the angulation is greater than 40° or if rotation is greater than 10° (Kollitz, 2014). This degree of angulation requires open reduction and internal fixation with the use of Kirshner wires or pins. Rotation is poorly tolerated as it is magnified with flexion and often results in scissoring, which interferes with grip. External reduction is required in a hard cast or brace for approximately four weeks. Activity during the time of healing is essential to prevent stiffness of the fractured area.

Although this is a frequently seen fracture in young active adults, it can usually be treated with fairly simple procedures, unless the angulation or rotation is severe.