Boxer's Fracture


BACKGROUND

DIAGNOSIS

TREATMENT

  Initial Treatment
Splint type & position Gutter splint: wrist, 30-degree extension; MCP, 70 to 90 degrees; PIP or DIP, 5 to 10
degrees
Initial follow-up visit Within 4-5 days for second or third metacarpal
Within 7-10 days for fourth or fifth metacarpal
Pt instructions Icing, elevation
 
  Follow-up Care
Cast or Splint type & position Gutter splint
Length of immobilization 3-4 wks
Healing time 4-6 wks
Follow-up visit interval Every 2 wks
Repeat radiography interval At initial follow-up to check for angulation or malrotation
Every 2 weeks to document position and healing
Pt instruction Begin ROM exercises after immobilization (handgrip strengthening)
Avoid contact sports for 4 - 6 weeks after immobilization or use orthotic protection
Indications for orthopedic consult Angulated or displaced fractures of second or third metacarpal
Malrotation
Angulation unacceptable to patient after closed reduction
Unable to hold reduction position
Malunion with painful grip or pseudoclawing