Fifth Metacarpal Fracture (Boxer's Fracture)

What is a fifth metacarpal fracture?

The metacarpals are the long bones in the hand. The fifth metacarpal is the bone in the hand that attaches to the pinky finger. A fracture is a break in the bone.

How does it occur?

A fifth metacarpal fracture usually occurs from hitting a hard object with your fist. That is why it is also called a boxer's fracture. It can also occur from falling onto your hand.

What are the symptoms?

Pain, swelling, and tenderness on the pinky finger side of the hand. There may be a bump on the side of your hand or it may look crooked.

How is it diagnosed?

Your health care provider will review your symptoms, ask you how you got the injury, and examine you. Your provider will take an x-ray of your hand, which will show the break.

How is it treated?

If the broken bone is crooked your provider will straighten it. Then a cast or splint will be placed from your hand to your forearm. You will wear this cast or splint for 4 to 6 weeks.

Treatment will also include:

• Elevating your hand by placing it on a pillow when you sleep or the back of a couch when you are sitting down.
• Putting an ice bag over the cast or splint for 20 to 30 minutes every 3 to 4 hours for the first 2 to 3 days.
• Taking anti-inflammatory medication or other medication prescribed by your provider.

When can I return to my sport or activity?

You may start your rehabilitation exercises when your provider has taken a follow-up x-ray sees that your fracture has healed.

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport or activity will be determined by how soon your hand recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

You may return to your sport or activity when your hand has full range of motion without pain and has the same strength as the uninjured side.

How can I prevent a fifth metacarpal fracture?

Since most fifth metacarpal fractures happen because of hitting hard objects with your fist...don't hit things!