Locations:
Boxer’s fractures get their name for how they usually happen: Punching something hard with a closed fist. They’re a type of broken bone, specifically the bone in your hand that connects to your pinkie finger. You’ll probably need to wear a splint or cast and take a break from sports for six to eight weeks.
A boxer’s fracture is a bone fracture (broken bone) in your hand. It’s a type of metacarpal fracture.
Your metacarpals are the bones in your hand that connect your thumb and finger bones (your phalanges) to your wrist. You can feel your metacarpals by pressing on the back of your hand.
A boxer’s fracture is a fifth metacarpal fracture (the bone that connects your pinkie finger to your wrist). It happens when you break the neck of the metacarpal — the end that joins your finger bones.
You’ll probably only need to wear a splint or cast while your bone heals after a boxer’s fracture. More severe fractures require surgery to repair — especially if you have other injuries.
A healthcare provider will classify your fracture as either open or closed. If you have an open fracture, your bone breaks through your skin. Open fractures usually take longer to heal and have an increased risk of infections and other complications. Closed fractures are still serious, but your bone doesn’t push through your skin.
”Displaced” or ”nondisplaced” are more words your provider will use to describe your fracture. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke (the bone is crooked and not lined up correctly).
Nondisplaced fractures are still broken bones, but the pieces weren’t moved far enough during the break to be out of alignment. Displaced fractures are much more likely to require surgery to repair.
Boxer’s fractures are the most common metacarpal fracture. They’re around one-quarter of all broken metacarpals.
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Boxer’s fracture symptoms include:
Punching or hitting something hard with a closed fist (like punching a wall in frustration) is the most common cause of boxer’s fractures. They get their name from being a common sports injury that boxers experience.
Getting hit on the back of your hand can also cause a boxer’s fracture.
Anyone can break their fifth metacarpal bone. Some groups of people are more likely to experience boxer’s fractures, including:
A healthcare provider will diagnose a boxer’s fracture with a physical exam and X-rays.
They’ll probably be able to feel or see a boxer’s fracture in your hand. Tell your provider what you were doing before you hurt your hand or when you first noticed symptoms.
Your provider will use X-rays to take pictures of your bones to confirm where your fifth metacarpal is broken and what the fracture looks like.
They may also use a computed tomography (CT) scan to take 3D pictures of your bones and the surrounding tissue (especially if you need surgery).
Your provider will suggest treatments to help your bone heal. Which treatments you’ll need depends on which type of boxer’s fracture you have and any other injuries you experienced. The most common treatments include:
If the boxer’s fracture is mild and your bones didn’t move far out of place (if it’s nondisplaced), you might only need a splint or cast. Most people need immobilization for three to six weeks. You’ll need follow-up X-rays to make sure your bones are healing correctly.
More severe boxer’s fractures may require a closed reduction to set (realign) your bones. Your provider will physically push the outside of your hand to line up your broken bones. To prevent you from feeling pain during the procedure, you’ll receive one of the following:
After the closed reduction, your provider will put your hand in a splint or cast.
Most people don’t need surgery for a boxer’s fracture.
But your provider may suggest surgery if you have an open fracture, a displaced fracture or a comminuted fracture (if the bone is broken in more than two places). You might also need surgery if the injury damaged tissue other than just your bone. You’ll be more likely to need surgery if the fracture causes malrotation (your pinkie finger crosses over your ring finger when you try to bend it).
Your surgeon will realign (set) your bones to their correct position and then, secure them in place so they can heal and grow back together. They usually perform an internal fixation, which means your surgeon will insert metal pins, screws or a plate into your bone to hold it in place. You might need follow-up procedures to remove the fasteners after your bone heals.
The most common boxer’s fracture surgery complications include:
It might take a few weeks for your symptoms to improve. Pain should start getting better in a few days, but it’ll take around six weeks for your bone to regain its full strength.
Depending on which type of immobilization or surgery you need to repair a boxer’s fracture, you should be able to start moving your hand again in a few weeks.
Contact your healthcare provider right away if you experience intense pain that doesn’t get better.
Follow these general safety tips to reduce your risk of an injury:
You should make a full recovery if you have a boxer’s fracture.
You’ll need occupational therapy to regain strength and range of motion in your hand.
Most people need a month or two to recover from a boxer’s fracture. How long it takes you to heal depends on the severity of the fracture and which treatments you need.
There are lots of factors that can affect how long it takes your body to heal. Talk to your healthcare provider or surgeon about a timeline that fits your specific situation.
You might have to miss work or school while your hand heals, especially if the boxer’s fracture is in your dominant hand (the hand you use most often to write or do other tasks).
Most people can resume physical activities (like playing sports) after eight weeks. Talk to your surgeon or healthcare provider before resuming any physical activities, especially if you broke your bone doing a specific activity or sport.
You need to see a healthcare provider as soon as possible if you think you have a boxer’s fracture (or any other type of broken bone). Go to the emergency room if you experience any of the following symptoms:
A boxer’s fracture won’t heal on its own. A healthcare provider needs to diagnose and treat all bone fractures. If you have an untreated boxer’s fracture, you have a much higher risk of complications like malunion.
Malunion happens when a broken bone heals back together, but not in the correct position or alignment. It can make it hard to use your pinkie finger in the future and increases the chances you break that bone again in the future.
Go to the emergency room as soon as you injure your hand and notice any boxer’s fracture symptoms. Even if your bone isn’t broken, a healthcare provider needs to examine and diagnose your injury.
A boxer’s fracture is a broken bone in your hand. Boxer’s fractures get their name for how they usually happen — punching something hard with a closed fist. They’re a common sports injury, but can also happen when you punch a wall or other hard surface when you’re angry or frustrated.
It’s annoying to miss several weeks of practices, meets or other activities, but you should make a full recovery after a boxer’s fracture. Don’t ignore symptoms like pain and swelling in your hand — especially after an injury. Visit a healthcare provider right away to get a diagnosis. The sooner they diagnose a boxer’s fracture, the quicker your broken metacarpal bone can start healing.
Last reviewed by a Cleveland Clinic medical professional on 10/16/2023.
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