Boxers Fracture or Fractured Metacarple | Physio4Life

Boxers Fracture or Fractured Metacarple

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Boxers Fracture or Fractured Metacarple





Fracture of one or more of the long bones (metacarples) that make up the palm of your hand (you can feel these best on the back of your hand).


The palm of the hand primarily comprises of 5 long bones known as the metacarpals. The metacarpal bones form joints with the small bones of the wrist known as the carpal bones and the small bones of the fingers known as the phalanges.


Direct impact to the hand (eg. a punch) will place stress along the bones in your palm. When this stress is traumatic and beyond what the bone(s) can withstand a break in one or more metacarpals may occur. This condition is known as a metacarpal fracture.


Due to the relatively large forces required to break a metacarpal bone, a metacarpal fracture is often seen in association with other injuries to the wrist or fingers such as joint sprains, dislocations or other fractures of the hand or wrist.





Sudden onset of acute and severe pain throughout the hand.  Sometimes this pain can settle relatively quickly leaving a dull and diffuse ache behind (this can be particularly bad in the morning).  This is likely to be accompanied by swelling and loss of function of the hand and fingers.  It is likely that the site of injury will be very sore to touch


If the fracture is severe enough, there may be some displacement of the bone.  This may even heal with a different appearance to before the fracture.  This is unlikely to have any impact on the use of the hand.





Clinical questioning will help to reveal the history of the injury and any common signs and symptoms of the problem.


Clinical examination will involve observation of the injured area, and the amount of swelling and bruising.  Feeling of the area will highlight any focal points of tenderness that may well be directly over the fracture site.


If a fracture is suspected, an X-Ray will help to confirm the diagnosis and the extent of the injury.  It will also help determine if surgical input is needed (if the two bone ends are severely displaced).







Sometimes this injury can be complicated because the two bones ends can rest out of alignment.  If this is the case, the doctor will need to reduce the injury (put bone ends together).  This would be done under anaesthetic.  In rare cases, surgery may be needed to place a more rigid support for the bone whilst it heals.


More commonly, treatment for this injury would require nothing more than the use of a dint or plaster cast to limit the hand movements whilst healing takes place.  This is likely to be for 4-6 weeks (the time would vary from case to case).  Once the bone has healed sufficiently, rehabilitation can begin as guided by your physiotherapist.


Physiotherapy for other nearby but uninsured joints could start whilst in cast/splint.  When out of the splint, rehabilitation will focus on regaining hand function and strength through both stretching and a progressive strengthening program.  Massage can help to release stiff and tight tissues and to mediate the pain also.  Steadily increasing the use of the hand (under the guidance of your Physio) will help the hand get back to normal.














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