You have been treated for a fracture/broken bone of a long bone of the hand. You have had a thorough examination and are now considered fit to be discharged. The following instructions will aid your recovery.
What is a Boxer’s Fracture?
This is a fracture/broken bone of the 5th metacarpal, which is a long bone of the hand. This injury is often sustained from punching an object with a closed fist, which results in a direct impact onto the knuckles. This can lead to pain, swelling and bruising in the hand. There may also be a change in the shape of the knuckle.
What will happen to my hand?
- The bone will take 4–6 weeks to heal. During this time your pain and swelling will improve gradually. Once the bone has healed you may notice a change in knuckle shape. This is common as a result of new bone formation and is a permanent change in shape.
- It may be difficult to lift your little finger upwards off a table when the hand is flat for a period up to 6 months, therefore the advanced exercises provided should be performed.
What is the best management?
- In most cases this type of fracture does not need a specialist review as operations are not generally required, therefore, they can be successfully self managed with education and exercises.
- To reduce your swelling try and keep your hand elevated with the use of a sling or pillows. Ice can also be applied to the area. Use a bag of frozen peas over a damp cloth for 20 minutes every 2 hours.
- To reduce your pain take regular pain relief such as paracetamol unless otherwise instructed.
- Your ring and little fingers can be strapped or taped together for 1–2 weeks. This can aid pain relief whilst allowing movement. When re-applying the tape ensure the finger joints are left uncovered.
- Following a Boxer’s fracture early exercise is beneficial for your recovery. Some simple hand exercises can be carried out until you are fully recovered. Exercises 1–3 can be started straight away as pain allows and then progressed after 2 weeks to exercises 4–5. These exercises should be carried out within pain limits.
When can I return to normal activity?
- If your job does not entail manual labour we would encourage you to return to work as soon as you feel comfortable. If your job involves manual work or you play sport you may need longer to recover.
If you have any concerns regarding this injury after one month you are welcome to visit your GP and they can arrange follow-up with an Orthopaedic specialist.
What exercises should I do?
Exercise 1: Finger flexion – Monkey Grip
Method: Gradually curl your fingers into a hooked position as in the diagram with your wrist bent backwards slightly. Hold for 5 to 10 seconds and release.
Repeat 5 times every 2 hours.
Exercise 2: Finger flexion – Grip
Method: Gradually bring your fingers in to make a fist. Initially this may be difficult to do, therefore stop at the point of pain. Hold for 5 to 10 seconds and release.
Repeat 5 times every 2 hours.
Exercise 3: Finger extension
Method: Place your hand flat on a flat surface and gradually curl your fingers backwards while keeping your palm firmly on that surface. Stop at the onset of pain.
Repeat 5 times every 2 hours.
Advanced exercises to be performed after 2 weeks:
Exercise 4: Little finger extension
Method: Place your hand and all fingers flat on a surface and gradually lift your little finger upwards. Initially you may have difficulty lifting this finger, however continue to attempt this exercise. Stop at a point of pain.
Repeat 5 times every 2 hours.
Attempt to lift your little finger higher each time. Be patient with this as it may take some time before you can lift this finger off the flat surface.
Exercise 5: Holding a ball
Method: Use a small ball for example a tennis ball. Hold onto the ball and gradually squeeze. Keep squeezing for 10 to 20 seconds and then release. Stop at the point of pain.
Repeat 5 times every 2 hours.
You can vary this by using soft or hard balls of different sizes.
Other people who can give medical advice are:
- Your GP
- 111 Service
- Your Local Pharmacist
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