Boxer’s fracture; Metacarpal fracture
The 5 bones in your hand that go from your wrist to your thumb and fingers are called the metacarpal bones.
You have a fracture (break) in one or more of these bones. This is called a hand (or metacarpal) fracture. Some hand fractures require wearing a splint or a cast, and some need to be repaired with surgery.
Types of Hand Fractures
Your fracture may be:
On your knuckle
Just below your knuckle (sometimes called a boxer’s fracture)
In the shaft or middle part of the bone
At the base of the bone, near your wrist
A displaced fracture (this means part of the bone is not in its normal position)
If you have a bad break, you may be referred to a bone doctor (orthopedic surgeon). You may need surgery to insert pins and braces to repair the fracture.
What to Expect
You will likely have to wear a splint. The splint will cover part of your fingers and both sides of your hand and wrist. Most people wear a splint for about 3 weeks.
Your health care provider will tell you how long to wear your splint.
If you had surgery, you may have a cast instead of a splint.
Most fractures heal well. After healing, your knuckle may look different or your finger may move in a different way when you close your hand.
Some fractures may require surgery. You will likely be referred to a bone doctor (orthopaedic surgeon) if
Your metacarpal bones are broken and shifted out of place
Your fingers don’t line up correctly and
Your pain is severe or becoming worse.
Self-care at Home
You may have pain and swelling for 1 or 2 weeks.
To reduce this:
Apply an ice pack to the injured area of your hand.
Keep your hand raised above your heart.
For pain relief, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), aspirin, or acetaminophen (Tylenol). You can buy these pain medicines without a prescription.
Talk with your health care provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
Do NOT give aspirin to children.
Follow the instructions about your splint that your health care provider gave you. Your provider will tell you when you can:
Start moving your fingers around more while wearing your splint.
Remove your splint to take a shower or bath.
Remove your splint and use your hand.
Keep your splint or cast dry.
You will likely have a follow-up exam 1 - 3 weeks after your injury. For severe fractures, you may need physical therapy after your splint or cast is removed.
You can usually return to work or sports activities about 6 - 8 weeks after the fracture. Your health care provider or therapist will advise you.
When to Call the Doctor
Call your health care provider if your hand is:
Tight and painful
Tingly or numb
Red, swollen, or has an open sore
Hard to open and close your after your splint or cast is removed
Also call your health care provider if your cast is broken down or it is putting pressure on your skin.
Webb CW. Metacarpal fractures. In: Eiff MP, Hatch RL, eds. Fracture Management for Primary Care. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 4.
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