Rapid Review: Boxer Fracture

February 8, 2018

Reviewed January 2024

Boxer Fracture

  • Fifth metacarpal
  • Punching an object with closed fist
  • X-rays to measure angulation 
  • Evaluate for fight bite on physical exam
  • Ulnar gutter splint
  • Hand surgery consult for open fractures, malrotation, neurovascular injury  

Sample question:

A 17-year-old boy presents to the clinic with right-hand pain after punching a wall. Physical examination reveals swelling over the dorsum of the right hand with bony tenderness noted with palpation of the fifth metacarpal. What is the most likely diagnosis?

By Yehuda Wolf, MPA, PA-C

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