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Boxer's (or Brawler's) Fracture
- Fifth metacarpal neck fracture, usually secondary to a direct blow or closed-fist impact.
- Potentially an unstable fracture and difficult to maintain reduction due to tension from tendons and muscles in the hand.
- Up to forty degrees of angulation can be tolerated without repair, although there is potential for reduced hand function without repair. Any rotational deformity, however, must be corrected.
- Non-displaced fractures: RICE therapy, gutter splint, and Ortho follow-up.
- Displaced, rotated, or angulated fractures (>40 degrees): closed reduction may be attempted but surgical fixation usually required.
References
Many thanks to Dr. George Kochman for submitting this case!