ABSTRACT

This chapter presents a case study of a 22-year-old male software engineer who noted that his right hand was swollen and painful on all movements. This man has a fracture of the 5th metacarpal bone neck or a Boxer's fracture. It is a common injury seen in young men and caused by high kinetic transfer through a closed fist. Like all hand and wrist injuries, careful assessment is required. The patient's recollection may be clouded by drugs or alcohol at the time of injury or circumstances surrounding the injury may not be intentionally disclosed. Clinical evaluation should cover examination of each finger in turn with assessment of bone, tendon and nerves at each joint. A high arm sling is important post-immobilisation as there is a significant amount of associated soft tissue swelling and the patient referred to fracture clinic. Patients should be advised that they may have an alteration in their knuckle contour but function is good with hand physiotherapy.