2. A boxer fracture is a break in the bones of the knuckles. It has also been known as a Brawler’s fracture. Contrary to popular belief boxer’s rarely injure their hand in this manner. Typically this injury occurs as a result of a bar fight and other such events in which a person punches a wall or filing cabinet with a closed fist.

3. Signs/Symptoms of a boxer’s fracture are: Pain or Tenderness in the effected knuckles of the hand A snapping or popping sensation may be felt when the bone is broken One or more of the fingers could be misaligned Deformity to the broken hand may be observed A cut on the hand could also be associated with a boxer’s fracture. Although rare, these cuts may reveal a more severe form of boxer fracture.

4. In order to properly diagnose a boxer fracture, doctor’s use a few examinations such as X-rays The x-rays are taken from three different angles to get a thorough view of what could/could not be fractured. Physical examination After the x-rays the doctor will perform a complete physical evaluation. The doctor will ask you to make a fist to determine the extent of the injury. *In a case where an x-ray cannot reveal an obvious fracture, the doctor may prescribe more x-rays from special angles to look for a hard to find fracture.

5. The examining Doctor would also look for loose bodies in the hand which could be the result of: Punching another person in the mouth Being bitten by another animal Being cut with a sharp object A penetrating injury Abrasions or splinters from an object

6. Sometimes x-rays can bring up objects that are lodged into the hand, also known as foreign bodies. These foreign bodies can range anywhere from Glass Bone Metal Stone **Although plants and wood can also be present in the hand, x-rays usually won’t reveal these objects**

7. In the next few slides there are some pictures of hand x-rays used to help identify a boxer fracture or other common hand injuries.

13. Treatment options can be broken down into treatment at home and treatment by a doctor. As far as immediate “home” treatment goes (as in the time immediately after the injury) one should: Use an ice pack, if ice is not available a towel soaked in cold water will suffice Elevating the injured hand A cut at the time of injury can give way to infection and swelling, in case this happens, wash the cut with soap and water and cover it thoroughly with a bandage Immobilizing the injured hand is a great way to prevent further injury. The best way to do this is to hold the injured hand with the other hand. Also, do not try and lift any object with the injured hand. If these early precautions are not noticed, further damage to blood vessels, nerves, tendons and ligaments could occur.

14. A doctor may use the following remedies for a boxer fracture: Pain medication to help with the primary healing process and pain. This medication could include Tylenol or Advil or even more exotic medications Surgery if there is any serious dislocation of the metacarpal bones. Splinting or casting based on the severity of the injury

15. Upon a doctor’s prescription and treatment plan implementation, the following should occur. A follow up appointment within one week if there is not a serious dislocation. If a splint has been applied and there is increased swelling or numbness, the splint should be loosened and the patient should return to the emergency room. The most obvious action to take is to avoid aggravating the injury by avoid fighting situations and events of that nature. Physical Therapy is a common treatment option because the muscles of the injured hand could be weakened from not being used.