Rapid Review: Boxer Fracture

Reviewed January 2024

Boxer Fracture

• Fifth metacarpal
• Punching an object with closed fist
• X-rays to measure angulation 
• Evaluate for fight bite on physical exam
• Ulnar gutter splint
• Hand surgery consult for open fractures, malrotation, neurovascular injury  

Sample question:

A 17-year-old boy presents to the clinic with right-hand pain after punching a wall. Physical examination reveals swelling over the dorsum of the right hand with bony tenderness noted with palpation of the fifth metacarpal. What is the most likely diagnosis?