A boxer's fracture is a break in the neck of the fifth metacarpal bone in the hand. It gets its name because the injury is common in boxers who don't have much experience.

The metacarpal bones are the intermediate bones of the hand, which are found inside the flat part of the hand. They connect the bones of the fingers (phalanges) to the bones of the wrist (carpals). The fifth metacarpal is the metacarpal of the little (fifth) finger. The neck of the metacarpal bone is where the main shaft of the bone starts to widen outward toward the knuckle.

Boxers are not the only people who get a boxer's fracture. But the injury is most often caused by hitting something with a clenched fist. The force fractures the neck of the metacarpal bone below the little finger.

Your doctor will need to make sure you have a boxer's fracture and not another type of metacarpal fracture. Other types include a break at the shaft of the metacarpal or a break at the base of the little finger. These injuries may need different treatments.

Metacarpal bones are some of the most commonly broken bones in the hand. Many of these are boxer's fractures.

Usually, a boxer's fracture happens when you punch a wall or another solid object at a high speed. You also might get a boxer's fracture if you fall hard on your closed fist. The neck of the metacarpal bone is its weakest point, so it tends to fracture there.

Symptoms can include:

• Painful bruising and swelling of the back and front of the hand.
• Pain in the back of the hand in the area of the fifth metacarpal.
• A bent, claw-like little finger that looks out of alignment.
• Limited range of motion in the hand and the fourth and fifth fingers.

The knuckle also may not have its normal bumpy shape. Symptoms may be more or less severe, depending on how complex the fracture is. You might have only mild pain, or the pain might be more severe.

The doctor will ask about your medical history, your symptoms, and how you injured your hand. The doctor will also examine your hand carefully, checking for pain, strength, misalignment, range of motion, breaks in the skin, and other problems.

An X-ray of the hand can confirm a boxer's fracture.

Your treatment depends on how severe the fracture is. To start, treatment may include:

• Resting your hand for a few days.
• Keeping your hand above the level of your heart as much as possible for a few days.
• Icing your injury several times a day.
• Taking prescription or over-the-counter pain medicine.
• Wearing a splint or cast for a few weeks.

Before your doctor puts your hand into a splint, the bones may need to be put back into alignment. You'll most likely receive a local numbing medicine (anesthetic) to decrease pain, and your doctor will move the bones back into place. A splint is often used for the first week, until swelling goes down. The doctor will then put a cast on your hand. The cast will stay in place until your hand is healed. Depending on the type of break, you may need surgery to get the bones back into alignment.

You also may need to work with a physical therapist for a while as your fracture heals. You'll learn exercises to strengthen the muscles of your hand and keep them from getting stiff.

If you have a severe boxer's fracture, you may need surgery right away. For example, if your bone has broken through the skin or has broken in several places, you will most likely need surgery. You might also need surgery if you have a job or hobby that requires a lot of fine-motor movement of the hand, like playing the piano.

Even if you don't need surgery right away, you might need it at some point. If your hand doesn't heal as well as expected, surgery might be a choice.

If the fracture isn't treated, it can lead to a decrease in your ability to grip, limited range of motion of the finger, and an abnormal look to the finger. With treatment, these problems are usually minor, if they happen at all.

To prevent this type of fracture, avoid fistfights and punching solid objects. If you box, make sure you use the correct method and equipment.

Your doctor may give you some instructions about how to care for your fracture. Here are some general tips.

• Keep your bones strong by eating a healthy diet with enough vitamin D, calcium, and protein.
• Stop smoking to help your fracture heal more quickly.
• Keep your splint or cast from getting wet.

Your hand will be easy to injure again for 4 to 6 weeks after your splint is removed. You may need to use a hand brace if you return to contact sports during this time. Talk with your doctor about what makes sense for you.

Contact your doctor if:

• You have numbness or tingling in your fingers.
• Your fingers look blue.
• You have severe pain or swelling that gets worse.
• Your splint or cast gets damaged or wet, and you need a new one.

A boxer's fracture is a break in the neck of the fifth metacarpal bone in the hand. It usually happens when you punch an object at a high speed.

• Symptoms of a boxer's fracture include pain and swelling of the hand, limited range of motion of the little finger, and a misaligned finger.
• Your doctor can diagnose a boxer's fracture by asking about your health history and doing a physical exam and an X-ray.
• You might need treatment that includes simple rest, ice, pain medicine, and splinting.
• You might need surgery if your fracture is severe.

Use these tips to help you get the most from a visit to your doctor.

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your doctor tells you.
• At the visit, write down the name of any new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your doctor gives you.
• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you don't take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your doctor if you have questions, especially after office hours and on weekends and holidays.