Boxer’s Fracture

What Is Boxer’s Fracture?

A boxer’s fracture is a break through the bones of the hand that form the knuckles. Some doctors use the term “brawler’s fracture” rather than “boxer’s fracture.” Other names are metacarpal fracture, metacarpal neck fracture, hand fracture, boxing fracture, broken hand, and hand injuries.

Your hands’ metacarpal bones connect the bones in the finger to the bones in the wrist. There are five metacarpal bones — one to connect each finger to the wrist. All of them have the same anatomic structure: Each consists of the base, the shaft, the neck, and the head. The base is the part that attaches to the bones of the wrist. The shaft is the long, slender part of the bone. The neck is the part that connects the shaft to the head. The head of the metacarpal bone connects it to the bone of the finger. The head of the metacarpal bones forms the knuckle of a closed fist.  

A boxer’s fracture is a break in a metacarpal bone that connects the ring finger or the little finger to the wrist. These are known as the fourth and fifth metacarpal bones. Some doctors also include breaks in the neck of the second and third metacarpal bones in the definition of a boxer’s fracture. The second metacarpal bone connects the index finger to the wrist, and the third metacarpal connects the middle finger to the wrist.

Boxer’s Fracture Symptoms

The typical symptoms of a boxer’s fracture are pain or tenderness on the hand near one of the metacarpal bones, around the knuckle. You may also have pain when you move your hand or fingers.

• When a bone is broken, you may have snapping or popping sensations.
• Your hand may swell, discolor, or bruise around the injury site. You may also have some deformity of the broken bone or knuckle. You may notice movement of the broken bone fragments.
• If you press on the area, you’ll feel pain. It’ll also hurt to push the finger that attaches to the metacarpal bone inward.
• When making a fist, the finger that is hurt may appear misaligned. It may bend toward the thumb more than is usual. This is known as rotation, and it can be a sign of a more serious type of boxer’s fracture.
• A cut in the skin may also indicate a more serious type of boxer’s fracture.

Boxer’s Fracture Causes

Boxer’s fractures get their name from one of their most common causes — punching an object with a closed fist. This can happen during fist fights or from punching a hard object such as a wall or filing cabinet. Although less common, this type of fracture can also happen when the hand isn’t clenched and strikes a hard object.

Boxer’s Fracture Diagnosis

Your doctor will ask you what happened to cause the injury and they’ll do a physical exam. They’ll look for things like: 

• Deformity tenderness
• Swelling
• Discoloration
• Decreased ability to move the hand, wrist or fingers
• Numbness
• Unequal temperatures between the injured and uninjured hands
• A cut

Swelling and discoloration are common with fractures. This is because of direct trauma to the bone and surrounding muscles, ligaments, tendons, nerves, and blood vessels.

The doctor will ask you to make a fist to check your ability to move your hand. This helps determine the extent of the injury, as well as the type of treatment that may be needed. The doctor may also be able to determine if a ligament has been torn. Torn ligaments won’t show up on standard X-rays. If they think you may have a fracture, they’ll take X-rays of your hand to check.  

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Typically, the X-rays look at the hand from three different directions. Getting images from different angles makes it easier for the doctor to see possible fractures. They should be able to see if there’s a break and if so, tell what type it is. Sometimes, the doctor may order more X-rays, with special views to look for hard-to-find fractures.  

Depending on how the injury happened, it’s possible the X-rays will show an object — also called a foreign body — in your hand. Foreign bodies that may show up on X-rays are glass, bone, metal, and stones. This could happen if the injury came from: 

• Punching another person in the mouth
• Being bitten by an animal
• Being cut with a sharp object
• Having something go through your hand

When to seek medical care

Any time you have an injury and think you may have a fracture, contact your doctor. If the doctor is unavailable, go to an urgent care. 

If you’ve already been splinted or casted and have increasing pain, numbness, or tingling in the fingers on the casted arm, call your doctor. These could be signs of infection that will need a doctor’s care.

Boxer’s Fracture Treatment

Home care for boxer’s fractures can be divided into care prior to seeing a doctor and care after a diagnosis of a boxer’s fracture is made.

Boxer’s fracture home care before diagnosis 

The immediate goals of caring for an injured hand are to minimize pain, swelling, and the risk of infection of any open cuts. You also need to prevent further injury.

• Ice and elevation: The best approach to reduce pain and swelling is to apply an ice pack to the injured area. If ice isn’t available, placing a towel soaked in cold water on the injured hand will work. Elevating the injured hand will also help reduce swelling.
• Clean and treat cuts: An open cut suggests an open fracture. This type of break is at higher risk for infection and poor healing. All cuts should be washed with soap and water and then covered with a clean bandage right away.
• Immobilize hand: This helps prevent further injury from a fracture. You can do this by holding the injured hand in the uninjured hand. Take care not to use the injured hand to lift objects or perform any task that would place stress on it. Using a broken hand in such a way can cause further damage.

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Boxer’s fracture home care after diagnosis 

Home care after the diagnosis of a boxer’s fracture is based on how the doctor treated the hand. Home care includes pain management, cast or splint care, and monitoring for signs of infection.

• Pain management. Bones, like many other parts of the body, have nerve fibers that transmit the sensation of pain. Pain from broken bones is caused by swelling or by the broken bone moving. Once a broken bone is immobilized and you stop moving it, you should have less pain. If your doctor writes a prescription for pain medication, take the medication as prescribed. This will help alleviate pain and will minimize the risk of any unwanted side effects from the medication. For mild pain, over-the-counter acetaminophen (Tylenol) or ibuprofen (Advil) may be used as directed on the label. Talk to your doctor before you take these medicines.
• Splinting or casting. One or the other is used on all boxer’s fractures that don’t need immediate surgery. All splints and casts should be kept dry in order to maintain their strength. It’s possible for the cast to become too tight from the swelling of the fracture. When this happens, you may feel pain. Another sign is numbness or tingling in the fingers on the casted hand and the finger may become cool to the touch. If this happens, call your doctor.
• Care for wounds or stitches. You can get an infection in an open cut. Wounds should be kept clean and covered until healing is complete. If you have stitches to close a cut, the doctor will give you instructions on how to care for them and when they should be removed.  Follow these directions carefully to lower your chance of infection. Warning signs of infection include redness, red streaking away from the cut, warmth, or swelling around the site of the cut. Pus may also drain from the wound. Call your doctor if you have any of these signs.

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Boxer’s fracture medical treatment

The primary goals of treatment are to stop the hand from moving around so it can start healing and to help with the pain.

A splint should immobilize the joints above and below the site of injury. In the case of a boxer’s fracture, different types of splints may be used. One type of splint may extend from the fingers, with the fingertips exposed, to the forearm near the elbow. Another type that has been shown to be effective for some boxer’s fractures of the little finger is to buddy-tape the ring finger and little finger together. Your doctor will decide what type of splint will treat your fracture the best.

• When a boxer’s fracture happens, it is possible for a portion of the metacarpal bone to move out of alignment. This is called angulation. The amount of angulation will determine what type of treatment is needed to ensure proper healing. People with boxer’s fractures who have acceptable amounts of angulation may be splinted in the emergency department or doctor’s office.
• If there’s any degree of angulation in the second or third metacarpal bones you may need a referral to a hand specialist for possible surgical repair. Boxer’s fractures of the fourth and fifth metacarpal bones only need surgery if there’s a large degree of angulation and the bones cannot be moved into the correct place by pulling and pushing on them after the hand is numbed with anesthesia.
• Because broken bones can cause significant amounts of pain, pain management is an important aspect to treating broken bones. Pain management is best accomplished with anti-inflammatory medicines and pain relievers. Acetaminophen (Tylenol) or ibuprofen (Advil) usually provides good pain relief with few side effects. These over-the-counter medications, or any prescription pain medicines, should be taken as directed to decrease the risk of side effects.

Boxer’s Fracture Recovery and Follow-Up

Your doctor may ask you to follow-up with a bone specialist (orthopedic surgeon) or a hand specialist to ensure that the broken bone mends properly. The hand specialist may be either an orthopedic surgeon or a plastic surgeon who specializes in hand injuries.

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Dos

• Follow-up within 1 week of the initial injury, or sooner.
• Loosen your splint, notify your doctor, and return to the emergency department immediately if you had a plaster splint placed in your doctor’s office, or in the emergency department, and you develop increased pain or numbness in your fingers, or if your fingers become cold and blue.
• Go to your physical therapy appointments if your doctor recommends it.
• Eat healthy foods that include vitamin D, calcium, and protein.

Don’ts

• Get your splint wet.
• Smoke.
• Get into a fist fight or do other things that boost your chance of reinjury.

Boxer’s Fracture Prevention

The key to preventing boxer’s fractures is to avoid situations in which the injury can happen.. Boxer’s fractures happen most often during fist fights and when someone punches a hard object in anger or frustration. 

Slowing the loss of bone that occurs naturally with age can also help avoid boxer’s fractures. You can help stave-off bone loss by getting regular exercise and getting enough calcium either through dairy products, fortified foods or supplements. Talk to your doctor about what may be best for you.

Boxer’s Fracture Outlook

With proper immobilization of the broken bones and good follow-up with a hand specialist, most people with a boxer’s fracture have a good outcome. If you need surgery, you may have a longer period of recovery than someone who only needs splinting. Some will need physical therapy after the splint is removed because the muscles become weakened from not being used.

Complications of Boxer’s Fracture

Complications aren’t likely if you get treatment for boxer’s fracture. If you don’t get treatment, complications may include:

• A decrease in your ability to grip
• Limited range of motion of the finger
• An abnormal looking finger

Long-term effects

Boxer’s fracture that is treated properly and soon after the injury happens is likely to fully recover with few long-term problems if any.

Boxer’s fracture: Treatment, diagnosis, and recovery

A boxer’s fracture is a break to one or more of the bones that make up the knuckle, called the metacarpals. A boxer’s fracture can also be called a metacarpal fracture and is less commonly referred to as a brawler’s fracture.

This kind of hand fracture is caused by an impact to the knuckle and is the most common type of metacarpal fracture. The severity of the injury depends in part on how much of the metacarpal bone is damaged.

Metacarpal bones consist of a base, shaft, head, and neck. The base is the part that attaches to the bones of the wrist. The shaft and neck portions of the bone run through the hand towards the fingers. The head of a metacarpal bone connects it to the bone of the finger. The heads of the metacarpal bones form the knuckles of the fist.

Fast facts on boxer’s fracture:

• The fracture typically occurs in the neck of the metacarpal, which connects the main shaft of the bone to the head.
• The term was originally used to describe only breaks in the fifth metacarpal, which is the bone of the little finger.
• This is the most common break when someone hits a hard or immoveable object.
• Treatments vary depending on the severity of the injury.

The definition has been expanded to include many metacarpal bone fractures caused by similar impacts.

Boxer’s fracture should not be confused with boxer’s knuckle, which is caused by repeated damage to the ligaments over time.

Share on PinterestBoxer’s fracture is so called because it is commonly caused by direct imapct to the knuckles, for example when punching something.

As the name would suggest, a boxer’s fracture is frequently caused by punching something. The knuckles are not designed to handle such impact, and fractures are a common consequence of a fight or someone punching a wall or other hard surface.

It is possible to get a boxer’s fracture without throwing a punch, however. Smacking a flat hand against a hard surface can be enough to cause a fracture, as well as dropping something heavy on the knuckles.

Symptoms of a boxer’s fracture usually follow a similar pattern to those of other broken bones. Symptoms of a boxer’s fracture include:

• swelling on both sides of the hand, typically appearing soon after the trauma
• pain surrounding the area
• extreme tenderness near the broken bone
• limited mobility in the fingers
• snapping or popping sensation in the affected bone
• deep or painful bruises
• difficulty gripping or inability to grip without feeling pain
• nerve symptoms, such as numbness, coldness, or tingling sensation

Symptoms usually begin quickly after the break, with most being felt within the first 24 hours. A boxer’s fracture needs medical attention. If a doctor cannot be reached for instruction, a person should go to the emergency room.

Share on PinterestA boxer’s fracture may be diagnosed using an X-ray.
Image credit: Roberto J. Galindo, (2010 February 23).

Diagnosing a boxer’s fracture usually requires a physical examination and imaging tests.

A doctor will ask how the injury happened, to narrow down the possibilities quickly, especially if the hand is too swollen to tell what is damaged.

Doctors use a few methods, during a physical exam, to help them identify the fracture. They may:

1. Put slight pressure on each bone to determine where the break is.
2. Gently push each finger towards the knuckle to see, which causes pain and determine where the injury is.
3. Ask the person involved to make a closed fist. The affected finger or fingers may look misaligned with the others. The affected fingers may also rotate towards the thumb more than normal.

Imaging tests are ordered, as well, even if the doctor is sure of their diagnosis. This is typically an X-ray image, which can confirm or determine, which bone is broken. Confirming the diagnosis through X-ray is critical, as treatment can vary greatly, again, depending on, which bones in the hand are damaged.

Boxer’s fracture seems simple and straightforward. Yet the injury can vary greatly in severity and may include one or more other broken bones. Treatment is not as straightforward as many other fractures. There are many different options that will be discussed with someone before moving forward.

Home care

Immediately after a fracture is suspected, it is important to reduce swelling and pain, and reduce the chances of infection. Ice packs can be used to limit swelling and pain.

It is important to immobilize the hand, as soon as possible. When the injury is unknown, it may be best to simply hold the injured hand in the non-injured hand, to keep it still. Any actions that put any stress on the hand at all should be avoided until the injury can be diagnosed.

After diagnosis, home care will often include cast or splint care, pain management, and checking for signs of infection.

Medical treatments

Treatment options for boxer’s fracture can include immobilization through splints or casts and might necessitate surgery. This depends on the severity of the fracture. Medical treatment will also include pain control.

Immobilization

The primary goal for medical treatment of a boxer’s fracture is to immobilize the hand to allow the bones to heal properly. Doctors usually employ various splints to do this job, though casts may be necessary, as well. The splint or cast should completely immobilize the joints above and below the site of the injury. This keeps stress off the injured bone and allows it to heal.

Surgery

Cases of a more severe boxer’s fracture will require surgery. This is especially true in instances where bones show signs of angulation. Angulation occurs when a part of the metacarpal bone moves out of its normal alignment. The amount of angulation can change the treatment method. Minor angulation may simply require a splint, but stronger degrees of angulation may require surgery.

In all cases of boxer’s fractures, people will be asked to follow up with an orthopedic surgeon. The surgeon will check if the healing is progressing well and help decide if surgery is needed to mend the bones.

Share on PinterestPhysical therapy may be needed to help the hand to recover, and restore motor skills.

The recovery time will vary based on how severe the injury is. A simple fracture may heal in several weeks, where more severe fractures can take months to do so.

During the recovery period, it is important to regularly check in with a doctor and hand specialist to track the healing process. The treatment plan they lay out should always be followed to ensure proper healing. Any at-home exercises or physical therapy that doctors prescribe will be imperative for proper recovery and should be closely followed.

Some people find splints irritating and are tempted to take them off. Keeping the splint on at all the times that are recommended by a doctor gives the fracture the best chance of healing without complication.

Left untreated, a boxer’s fracture can create complications for someone, such as leaving them unable to grip objects, with crooked fingers, or decreased range of motion.

On the other hand, a boxer’s fracture that is quickly diagnosed and treated will usually heal with little to no long term effects. Proper medical diagnosis and treatment is critical for good healing and to ensure the best outcome.

Boxer’s fracture • LITFL • Trauma Library

Boxer’s Fracture (5th Metacarpal neck fracture):

• AKA = Intellectually Destitute Fracture
• A fracture of the forth or fifth metacarpal neck with volar displacement of the metacarpal head.
• One of the most common injuries seen in the ED, and occurs in 20% of patients that punch a hard object.
• The typical symptoms of a boxer’s fracture are pain or tenderness centered in a specific location on the hand corresponding to one of the metacarpal bones, around the knuckle.
• The patient may be reluctant to disclose the mechanism of injury related embarrassment, or fear or repercussions if they disclose it occurred in a fight. A high clinical suspicion should be used when assessing these injuries.
• If injury occurred during a fight, look for other injuries as well.

Clinical appearance of Right Boxers fracture

Emergency management of boxer’s fractures.

• Rest, Ice, Sling for support, Elevation
• Simple Analgesia= Paracetamol-codeine, NSAIDs.
• X-ray: AP and Oblique view should be obtained; lateral views can help with assessing angulation and other injuries in the carpometacarpal area.
• Open fractures require antibiotics, refer to local guidelines
• Severe fractures occur if angulation is greater than 45° or if rotation is greater than 20° external reduction is required.
• Refer to orthopaedics or hand surgeon

Treatment Options:

Currently there is no consensus on the correct management of boxer’s fracture.  Immobilisation, functional treatment/minimal immobilisation can all be used with similar result. Discussion of the case with local hand or orthopaedic surgeon, will develop treatment plan and follow up, and will generally guide further management.

Immobilization:

• Closed reduction and external fixation with a brace or functional tapping, can sometimes align fracture ends sufficiently.
• Most frequently used is a dorsal plaster slab and finger extensor.
• Open reduction and internal fixation using Kirshner wires, and a dorsal stainless steel loop can also be used in severe fractures.

Impacted Boxer’s Fracture Requiring Fixation

Minimal Immobilisation:

• Minimal mobilisation is effective depending on the degree of angulation and rotation of the metacarpal head, and is tending to become the more preferred method of managing boxers fractures.
• Minimal immobilisation can be considered when angulation greater than 45° with little or no rotation and slight displacement.
• With functional taping this is achieved by using elastic tape and buddy strapping the fourth finger against the fifth, with padding between them, to prevent deformity and pressure  areas. A broad circular strap or compression glove supports the hand, which does not limit range of motion in any joint.

Metacarpal Fracture Splint

Follow-up and Discharge:

• If patients not admitted for operative repair, they should have follow up arranged at the orthopaedic or hand surgeon’s outpatient clinic.
• Psychiatric assessment should be part of the treatment of patients who present to outpatient clinics or emergency department with a Boxers Fracture. This can assess for anger management issues or antisocial traits that need addressing.

Reference

• Altizer, L. (2006). Boxer’s Fracture. Orthopaedic Nursing. 25(4), 271-273.
• Heins, K. & Heins, A. (2008). Management of Emergency Department Patients with Boxer’s Fractures: Functional Treatment or Immobilization. Advanced Emergency Nursing Journal. 30(4), 289-296.
• Mercan, S. et.al. (2005). Psychopathology and personality features in orthopaedic patients with boxer’s fractures. General Hospital Psychiatry. 27, 13-17.

Emergency nurse with ultra-keen interest in the realms of toxicology, sepsis, eLearning and the management of critical care in the Emergency Department | LinkedIn |

Boxer’s Fracture | Symptoms, treatment, surgery & rehabilitation

James Paci, M.D.

A boxer’s fracture is a fracture, or break, of the fifth metacarpal bone of the hand, at the metacarpal neck. This is the bone associated with the small finger. When fractured, usually after punching an object like a boxer, it is often angulated and/or displaced requiring reduction and or surgical fixation.

Click the following link to learn about a metacarpal fracture. 

Anatomy related to a boxer’s fracture 

The hand is made up of five metacarpal bones, numbered one to five from the thumb side to the small finger side of the hand, and fourteen phalanges or finger bones. The fifth metacarpal gives structure to the medial boarder of the hand and can be felt below the skin. The lumbrical and interosseous muscles, attached to the fifth metacarpal, cause the fracture to angulate apex dorsal, towards the back of the hand. 

Causes of boxer’s fracture 

A boxer’s fracture is usually the result of punching a hard object with an unprotected fist. The fifth metacarpal bone is loaded along its longitudinal axis through the metacarpal head at the metacarpalphalangeal joint, or knuckle, and fractures in the shaft of the bone. A combination of this axial load and the deforming forces of the lumbrical and interosseous muscles cause an apex dorsal angulation.

How does one examine a boxer’s fracture? 

Physical examination of a boxer’s fracture focuses on determining the orientation of the fracture and its effect on the rotation of the small finger. The examination needs to make sure that there is no overlap of the small finger on the ring finger or significant divergence from the ring finger when compared to the other side. A complete neurovascular examination of the hand and small finger is performed to make sure that the nerves and vessels to the finger are uninjured. Radiographs, or x-rays, of the hand in multiple planes are used to determine the fracture orientation, including angulation and displacement.

When to See the Doctor

Hundreds of athletes sustain acute injuries every day, which can be treated safely at home using the P. R.I.C.E. principle. But if there are signs or symptoms of a serious injury, emergency first aid should be provided while keeping the athlete calm and still until emergency service personnel arrive. Signs of an emergency situation when you should seek care and doctor treatment can include:

• Bone or joint that is clearly deformed or broken
• Severe swelling and/or pain,
• Unsteady breathing or pulse
• Disorientation or confusion
• Paralysis, tingling, or numbness

In addition, an athlete should seek medical care if acute symptoms do not go away after rest and home treatment using the P.R.I.C.E principle.

Potential complications of a boxer’s fracture 

Over angulation of a boxer’s fracture can lead to a prominent metacarpal head felt in the palm of the hand, and cause decreased grip strength. Further, a rotationally malaligned metacarpal can cause a grasp abnormality. Splinting or casting of the hand in a position other than intrinsic plus position can lead to an extension contracture at the MCP joint and dysfunction of the hand.

Boxer’s fracture splint 

Conservative treatment of a boxer’s fracture is warranted in most situations where there is not significant fracture angulation and there is no significant rotational deformity. Conservative care involves possible fracture reduction, often requiring local anesthetic, followed by boxer’s fracture splint or casting of the hand and small finger in the intrinsic plus position (MCP flexion, PIP and DIP extension). Allowing for some digital motion may produce improved results. 

Acceptable angulation is less than thirty degrees, with decreasing grip strength associated with increased angulation. The period of immobilization should last three to four weeks, followed by protective splinting until six weeks, with fracture healing requiring six to ten weeks.

More Information: Read about sports injury treatment using the P. R.I.C.E. principle – Protection, Rest, Icing, Compression, Elevation.

Surgical options 

Surgical treatment is indicated for those fractures with unacceptable angulation or rotation, or a reduction that is not stable in a splint or cast. Surgical fixation methods range from transmetacarpal or interosseous pinning to plate and screw fixation. High level athletes may opt for internal fixation to allow for the potential of earlier return to play.  K-wire fixation is often used for better cosmetic results. Surgical fixation adds the usual surgical risks of infection, neurologic injury, and bleeding, as well as the risks of hardware failure and extensor mechanism injury.

What is the prognosis for an athlete suffering a boxer’s fracture? 

The long term prognosis of a boxer’s fracture is good. Although highly angulated fractures tend to heal, one may have decreased grip strength, which is rarely clinically significant. In the athlete however, one may be more aggressive with fixation. Internal fixation allows for return to play in a protective cast or splint within two weeks of surgery. One must remain protected however until full osseous union at 6-10 weeks. The athlete’s age, level, sport, position and time of season must all be taken into account when deciding on a treatment plan.

References

• DeLee, Jesse, David Drez, and Mark D. Miller. Delee & Drez’s Orthopaedic Sports Medicine : Principles and Practice. 3rd ed. Philadelphia: Saunders/Elsevier, 2010. Print.
• Henry, M. H. “Fractures of the Proximal Phalanx and Metacarpals in the Hand: Preferred Methods of Stabilization.” J Am Acad Orthop Surg 16 10 (2008): 586-95. Print.
• Morgan, W. J., and L. S. Slowman. “Acute Hand and Wrist Injuries in Athletes: Evaluation and Management.” J Am Acad Orthop Surg 9 6 (2001): 389-400. Print.

BOXER’S FRACTURE | Sports Medicine Today

What is it?
A boxers fracture is a break (fracture) in one of the metacarpal bones of the hand. These bones connect the finger bones to the wrist bones and help form the knuckles. This type of fracture most commonly occurs when a person punches a hard object with a closed fist, thus the name boxers fracture. The fifth metacarpal, or pinky finger, is most commonly injured, followed by the fourth, or ring finger. Most breaks are in the neck, or top, of the metacarpal bone near the knuckle.

Symptoms
A patient with a boxers fracture may hear a crack or pop at the time of injury. He will likely have pain around the fracture site, along with swelling, bruising, or discoloration. His knuckle may also look different or flat if the break was severe.

Sports Medicine Evaluation
A sports medicine specialist will obtain a history and carefully examine the injured hand for deformity, tenderness, swelling, and discoloration. He will also assess finger
and hand sensation, along with movement, which may be decreased. X-rays may be obtained to diagnose the broken bone and determine treatment.

Sports Medicine Treatment
Initial treatment with ice and elevation of the hand can lessen the swelling. Medications can also help with pain and swelling. Most fractures will only require immobilization in a cast or splint for 3-6 weeks. If there is a cut or break in the skin at the time of the injury, the fracture is considered high-risk for infection. Antibiotics are often prescribed to decrease the risk of infection. Assessment by a surgeon may be
needed. In addition, a surgeon may need to be consulted if the fracture is severely bent
or displaced.

Injury Prevention
The most important way to prevent a boxers fracture in combat athletes is to learn proper punching technique, so initial contact is not with the fourth and fifth knuckles. These athletes also routinely wrap their hands or use boxing gloves to protect themselves from injury when training.

Return to Play
Athletes can return to sports once they are pain-free with normal hand and finger movement, and have x-ray evidence of fracture healing. Often, in contact sports, a padded removable hand splint is used to protect the injury if it does not interfere with activity, and is allowable.

AMSSM Member Authors
Sarah Kinsella, MD and Margot Putukian, MD

References
Giddins GE. The non-operative management of hand fractures. J Hand Surg Eur Vol. 2015 Jan;40(1):33-41. Epub 2014 Sep 12.

Leggit JC and Meko CJ. Acute Finger Injuries: Part II. Fractures, Dislocations, and Thumb Injuries. Am Fam Physician. 2006;73(5):827-834.

Boxer’s Fracture | Summit Orthopedics Condition Guide

What is a boxer’s fracture?

A boxer’s fracture is a break in the fifth metacarpal bone of the hand. The metacarpals are the long bones inside the palm. The fifth metacarpal is the bone that connects to your little finger. Boxer’s fractures are the most common type of hand fracture.

Learn more about hand anatomy

Fractures happen when a force is applied to the bone that exceeds the strength of the bone. There are two general categories of fracture:

• In a nondisplaced fracture, the bone is broken but has not shifted or moved out of position.
• In a displaced fracture, the bone has shifted significantly and the fractured ends of the bone are no longer in proper alignment.

What causes a boxer’s fracture?

Boxer’s fractures typically happen when you punch a hard surface with a closed fist. The fifth metacarpal bone absorbs most of the punch’s force, causing injury. A boxer’s fracture can also happen during a fall — if you fall onto a closed fist rather than an outstretched hand.

What are the symptoms of a boxer’s fracture?

The symptoms of a boxer’s fracture vary depending on how severe the fracture is and whether it is a nondisplaced or displaced fracture. Common symptoms of a boxer’s fracture may include:

• Pain
• Tenderness and swelling around the knuckle of the little finger
• Bruising
• Difficulty straightening the little finger
• The little finger may cross over the next finger when making a fist (called “scissoring”)
• A visible deformity — the knuckle of the little finger may look sunken in

How is a boxer’s fracture diagnosed?

Most boxer’s fractures can be diagnosed through an X-ray and a complete physical exam. In specific situations, your specialist may wish to get an MRI (magnetic resonance imaging) or a CT (computed tomography) scan as well.

What are my treatment options for a boxer’s fracture?

A boxer’s fracture is typically immobilized with a cast or brace in order to correct bone alignment and prevent you from using the bone while it heals.

Your custom treatment plan may include:

• Splint
• Cast
• Buddy taping
• Pain medicines, such as acetaminophen
• Anti-inflammatory medicines, such as ibuprofen
• Physical therapy
• Surgery

Learn how to care for your cast

How long will it take the fracture to heal?

The average healing process for a boxer’s fracture is anywhere from six to eight weeks, but different people heal at different rates. It may be slightly longer if surgery is required.

At Summit, our primary goal is to make sure your bones heal properly so you can get back to your everyday active life as quickly as possible without any future symptoms or loss of function.

Summit Orthopedics provides personalized hand and wrist expertise

The function of our hands is integrated through our wrists and arms to our shoulders; a problem anywhere along our arm may have a significant impact on hand function and quality of life. If you experience an injury or uncomfortable symptoms, our fellowship-trained hand and wrist surgeons are here to help. Summit physicians receive the highest levels of training and exclusively provide individualized care for conditions of the hand, wrist, and elbow.

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Related resources for you

Boxer’s Fracture | Cedars-Sinai

Not what you’re looking for?

What is a boxer’s fracture?

A boxer’s fracture is a break in
the neck of the 5th metacarpal bone in the hand. It gets its name because the injury is
common in inexperienced boxers.

The metacarpal bones are the
intermediate bones of the hand found inside the flat part of the hand. They connect the
bones of the fingers (the phalanges) to the bones of the wrist (the carpals). The 5th
metacarpal is the metacarpal of the 5th (pinky) finger. The neck of the metacarpal bone
is where the main shaft of the bone starts to widen outwards towards the knuckle.

Boxers are not the only people who can get a boxer’s fracture, but usually the injury results from direct injury to a clenched fist. The force fractures the neck of the metacarpal bone below the pinky.

Your healthcare provider will need
to make sure you have a boxer’s fractures and not other metacarpal fractures, which
break the shaft of the metacarpal, or fractures of the base of the small finger. These
injuries may need different treatments.

Metacarpal bones are some of the
most commonly-broken bones in the hands. A large number of these are boxer’s
fractures.

What causes a boxer’s fracture?

Usually, a boxer’s fracture happens when you punch a wall or another solid object at a high speed. You also might get a boxer’s fracture if you fall hard on your closed fist. The neck of the metacarpal bone is its weakest point, so it tends to fracture here.

What are the symptoms of a boxer’s fracture?

Symptoms of a boxer’s fracture can include:

• Painful bruising and swelling of the back and front of the hand
• Pain of the back of the hand in the
  area of the fractured 5th metacarpal
• Bent, claw-like pinky finger that
  looks out of alignment
• Limited range of motion of the hand
  and of the 4th and 5th fingers 

Your knuckle may also not have its normal bumpy shape. Your symptoms may vary in severity depending on the complexity of your fracture. You might have only mild pain, or the pain might be more severe.

How is a boxer’s fracture diagnosed?

Your healthcare provider will ask
you about your symptoms, how you injured the hand, and your past medical problems. Your
provider will also examine your hand carefully, checking for pain, strength,
misalignment, range of motion, breaks in the skin, and other problems.

An X-ray of the hand can clearly confirm a boxer’s fracture.

How is a boxer’s fracture treated?

Your treatment depends on how severe the fracture is. Initial treatment might include:

• Washing any cuts in the skin
• Getting a tetanus shot if you have a cut and haven’t had a shot for several years
• Resting your hand for a few days
• Keeping your hand above the level of your heart for a few days
• Icing your injury several times a day
• Taking pain medicine (prescription or over-the-counter)
• Wearing a splint for several weeks

Before your healthcare provider
puts your hand into a splint, he or she may need to put your bones back into alignment.
Usually, you’ll receive a local anesthetic to keep you from feeling any pain, and your
provider will move the bones back into place. In some cases, you may need surgery to get
the bones back into alignment.

You also may need to work with a physical therapist for a while as your fracture heals. You’ll learn exercises to strengthen the muscles of your hand and keep them from getting stiff.

If you have an unusually severe
boxer’s fracture, you may need immediate and more complicated surgery. For example, if
your bone has broken through the skin, or if it has broken in several places, you will
probably need surgery. You might also need surgery if you have a job or hobby that
needs a lot of fine-motor movement of the hand, like playing the piano.

Even if you don’t need surgery right away, you might need it at some point. If your hand doesn’t heal as well as expected, surgery might be an option.

What are possible complications of a boxer’s fracture?

An untreated boxer’s fracture can
lead to a decrease in your ability to grip, limited range of motion of the finger, and
an abnormal looking finger. With treatment, these problems are usually minor, if they
happen at all.

What can I do to prevent a boxer’s fracture?

Avoid fistfights and punching solid objects to prevent many cases of boxer’s fracture. If you box, make sure you use the correct technique and the proper equipment.

How to manage a boxer’s fracture

Your healthcare provider may give
you some instructions about how to manage your boxer’s fracture, such as:

• Keep your bones strong by eating a healthy diet with enough vitamin D, calcium, and protein
• Stopping smoking, to help your fracture heal more quickly
• Keeping your splint from getting wet

Your hand will be very easy to
injure again for 4 to 6 weeks after your splint is gone. You may need to use a hand
brace if you return to contact sports during this time. Talk with your doctor about what
makes sense for you.

When should I call my healthcare provider?

Call your doctor if:

• You have numbness or tingling in your fingers
• You fingers look blue
• You have severe pain or worsening swelling
• Your splint gets damaged or wet and
  you need a new one

Key points about a boxer’s fracture

A boxer’s fracture is a break in
the neck of the 5th metacarpal bone in the hand. It usually happens when you punch an
object at a high speed.

• Symptoms of a boxer’s fracture include pain and swelling of the hand, limited range of motion of the pinky finger, and misalignment of the finger.
• Your doctor can diagnose your boxer’s fracture with a medical history, physical exam, and X-ray.
• You might need treatment with simple rest, ice, pain medicine, and splinting.
• You might need surgery for your injury if it is severe.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Not what you’re looking for?

90,000 Boxer’s Fracture: Exercises for Recovery | This is Boxing

Injuries in boxing are an exaggerated thing, but common. As they say, d … mo happens. We will not teach you how to protect yourself 100% and permanently get rid of the bruises that bloom on your face, like the gardens of Babylon. But let’s show you how to recognize one of the most insidious injuries in boxing, damaging the boxer’s main weapon – his arms.

What is a boxer’s fracture?

Boxers’ bones crack mainly in the area of ​​the nose, wrist and ribs.But most often the metacarpal bones are affected, so this fracture is called “boxer fracture.” This is a closed fracture – one in which the skin remains intact and the bones do not stick out. Damage occurs in the neck of the fifth metacarpal bone. Simply put, this is a fracture of the fifth bone from the thumb, which is located under the little finger.

Why does the fracture occur?

Primarily due to improper position of the hand upon impact or in cases where the load exceeds the strength of the bone.Most often, the fourth and fifth metacarpal bones are broken, since they are more fragile than the third (considered to be load-bearing) and the second, which are more resistant to mechanical stress. Therefore, the blow must be made with them (the second and third).

How to recognize an injury?

The most common symptom of a boxer’s fracture is hand swelling, when the skin on the fist becomes smooth, poreless, and looks like water was pumped under it. At the same time, pulsating pain appears, which increases with flexion and extension of the hand.There is numbness and coldness in the hand, and the ability to completely clench the hand into a fist is lost.

Since the boxer’s training is directly associated with constant impacts on a hard surface, despite the gloves protecting the hands, microtrauma can appear in the bones. For a long time they may not make themselves felt, but they have a cumulative effect. Most often, the first symptoms of a “boxer’s fracture” go unnoticed, as they manifest themselves with a little discomfort. Therefore, any pain that occurs too often is a reason to see a doctor.

How to recover from a “boxer’s fracture”?

In the first four weeks, while the bone is healed, the plaster of Paris becomes your faithful companion and ally, and after this time you can start performing recovery exercises. The shock load on the injured arm should be limited to two to three months.

Exercise number 1

Bend your arm at the elbow at 90 degrees so that the hand is at shoulder level and, leaving the forearm motionless, move the hand back and forth, as if saying goodbye to someone.

Exercise number 2

Squeeze your hand into a fist and start swinging, as if holding a hammer in your hand, with which you are driving a nail.

Exercise number 3

Turn your palm to your face and keeping your index, middle and ring fingers motionless, connect your thumb and little finger.

Exercise number 4

Put your hand on the table, as if preparing to donate blood from a vein, having previously armed with a can or a liter bottle. Then begin to lift the hand towards the shoulder without lifting the forearm.

Exercise # 5

Take the bottle again, stretch your hand forward, turn your hand so that your thumb is pointing down, then start raising and lowering your hand up and down.

Exercise number 6

The ball can be replaced with an expander, the main thing is not to take the simulator with great resistance.

Exercise # 7

Slide all five fingers inside the elastic and start slowly spreading from side to side, overcoming the resistance created by the elastic.

Be careful in training and in battle, then your bones will remain safe and sound. Be attentive to your health and see your doctor at the first sign of injury.

If you like the material – put your thumb up!

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Boxer’s fracture fifth metacarpal (little finger) fracture

In general, almost the most frequent fracture of boxers is a fracture of the fifth metacarpal bone. The fact is that small tubular bone tissues form the hands. The metacarpal bones take on special functionality. It is they who organize the whole process of flexion-extension of the fingers on the hands.

Picture 1 – Fracture of the “boxer” – the fifth metacarpal bone

It is the metacarpal bone, as it were, divided into three parts: the head, body and base. They are connected by thickened bases that are next to the bony wrists.

Their head looks like a ball, which has a slight bulge on the side of the palm.

Causes and types of injuries

Damage to the fifth and other metacarpal bones most often occurs due to an unsuccessful impact on a hard object. It can also occur with an ordinary fall on the hand. In special cases, injuries are still found due to pinching of the palm between objects, or when falling onto an open palm.

Despite the fact that these bones are very small, and especially the fifth metacarpal bone, all injuries can be divided into groups:

• Damage occurs on the spherical head itself.
• At the base of the fifth metacarpal bone.
• In the center of the fifth metacarpal bone.

In the sport of boxing, in practice, several types of fractures of the fifth metacarpal bone are very common. Of these, the following types are especially distinguished:

• Oblique, helical, angular and rotational damage.
• Fracture with displacement.
• Fracture with different numbers of debris formation after it.
• Fractures of types such as open, comminuted, or closed.

The most dangerous of the above types are still considered comminuted fractures of the fifth metacarpal bone and fractures with displacement.

Figure 2 – Metacarpal bone fracture

Treatment is individualized based on the type of fracture the patient has.

Symptoms

The symptomatology of this type of damage is very diverse. There are symptoms that make it difficult to unequivocally determine that the patient has a fracture and it is the fifth metacarpal bone. But on the other hand, all these symptoms, met together, will definitely indicate that we are dealing with a fracture of the fifth metacarpal bone.

Typically, boxers experience the following symptoms when the fifth metacarpal bone is fractured.

• The patient cannot clench his hand into a fist, even with great effort.
• The arm is swollen.
• The contour of the hand, and the hand in particular, is being changed.
• Hematomas appear at the site of the fracture.
• Any movement is accompanied by a crunch.
• On palpation, the deformation of the bone tissue is perfectly felt.
• Increase in acute pain when moving the hand.

How to provide assistance

In order to have as few consequences as possible after a fracture of such a value, it is necessary to carry out a number of conditions with the help of which negative consequences can be prevented.

All activities that need to be organized and carried out at the very first time after the fracture are aimed at minimizing the risks and negative consequences after a fracture of the metacarpal bone.

1. First you need to carry out such a procedure as hand immobilization. Also, the patient is especially recommended to refuse such movements, where at least somehow (directly or indirectly) the injured metacarpal bones are affected.
2. To prevent the formation of hematomas resulting from a fracture of the fifth metacarpal bone, or at least to minimize the number of existing ones, it is necessary to apply cold to the fracture site.
3. To normalize the state of health pain, it is necessary to take pain relievers, which will help reduce pain.

Picture 3 – Fracture of the fifth metacarpal bone

After first aid has been provided for a fracture of the metacarpal bone, the patient should be sent for examination to a hospital, where doctors will professionally examine the site of the fracture and do whatever is necessary.

To fix the bone in the first aid, you can use the tools at hand (book, stick, tablet). The position of the palm with a fracture of the fifth metacarpal bone will be curved. You do not need to straighten your palm.The main thing is to fix the position and wait for medical professional help.

Treatment of a fracture of the fifth metacarpal bone

As mentioned earlier, fracture treatment is determined depending on the location of the fracture itself and its type. In practice, most often only two types of treatment are prescribed – this is an operative method and a conservative one.

Conservative treatment

This method is mainly chosen when the injury itself does not pose a complex and dangerous threat to human life and activities.A plaster cast is applied to the injured limb. This bandage is removed in about a month and a half. Before that, taking preventive measures in the form of an X-ray.

Surgical treatment

If the fracture is rather complex, then you cannot do without surgical intervention. This method is preferred when the fragments are at a rather distant distance from each other. This means that the fragments and the bone itself will not be able to grow together without the help of a surgeon.

Rehabilitation

In order for the rehabilitation period to pass easily and comfortably for the patient, a certain set of rules and tips must be followed.

When the plaster bandage is removed from the patient’s arm after the expiration date, his movements become constrained. He also feels some discomfort.

In this case, the adopted set of measures will suit the patient. For example, physiotherapy exercises.

If all the necessary measures are followed, after about a few days, mobility in the joints returns again. It is then that the former skill of wiggling fingers returns.

Picture 4 – Boxer’s Fracture

It is worth paying particular attention to the patient’s nutrition. In general, give preference to such products where a large amount of calcium is detected.

Prevention

As they say – there is no better treatment than prevention. The most important thing a boxer needs to observe is personal precautions. Also, do not forget about safety precautions. Control your own physical activity. Particular attention should be paid to those people who lift heavy weights.

For those people who value the health of their own bones, it is necessary to take strengthening vitamins, as well as do daily workouts.

90,000 Bone fractures or mystery covered with plaster.

Seeing a man in a cast, I remember myself in elementary school. No, not because I broke something for myself. It’s just that I often had such a desire. With plaster, they begin to pay too much attention to you, almost a hero – to endure such pain. What kind of pain? What a hero? A naive childish worldview …
In most cases, bones are broken by people with impaired coordination of movement and spatial perception, or with fragile bones.This happens in everyday situations, sometimes even stupid ones. Yes, heroes are good! But in fact, no one is immune from bone fractures. It’s just that athletes in everyday situations do this less often, for example, when he falls, he manages to group up and land safely.
But we, athletes, are the same people. And by playing various sports, we are even more at risk of injury. I already talked about the reasons that lead to this in the article “Injuries in kickboxing”. I will not repeat myself and return to the main topic.
Fractures are a violation of the integrity of the bone under the simultaneous influence of an external force that exceeds the margin of safety of the bone. If the integrity of the bone is not completely broken, then a crack, fracture or perforated defect of the bone tissue may occur.
What fractures can occur in kickboxing? Kickboxing refers to the martial arts where punches and kicks are applied. It would seem that everyone favors permanent injuries and fractures as well. But in fact, this is more the exception than the rule! Reliable equipment and strict rules for conducting a fight minimize fractures in kickboxing to a minimum.But they do happen even during normal workouts.

• From a strong blow to the nose, the cartilage is displaced from the bone to which it is connected or breaks below it. A rupture occurs in the blood vessels, resulting in nosebleeds, sometimes severe. Applying ice to the nasal area and applying pressure stops the bleeding. In case of displacement, you will have to consult a specialist to straighten your nose. Swelling and pain accompany this injury. Also, get ready for the “beautiful fingals” under both eyes)) Broken nose – the calling card of boxers!
• Heavy blows to the body may cause rib fracture or ribs.Often, such an injury is a serious obstacle to the continuation of the fight, since it is difficult to breathe. In severe cases, a broken rib can penetrate into the chest cavity and lung. The recovery period will depend on the number of broken ribs.
• Orbital fracture of bones around the eye is quite dangerous. In this case, there is a sharp pain, swelling around the eyes (I immediately remember the film “Rocky”) and can lead to damage to the eye itself. The fracture can heal without any intervention, but if the bone floats or shifts into the orbit of the eye, then surgery will be required.
• Fractures of the fingers are common, especially in beginners. Either they will not clench the fist, then the toe of the leg does not pull on impact. But experienced boxers and kickboxers may have fractures of the 2nd or 3rd metacarpal bone. Such an injury is difficult to determine on an X-ray, and if the structure of the bones is poorly restored, the injury will remind of itself with strong blows with the hands.
• Fracture of the lower jaw in kickboxing can occur from a blow with an arm or leg at the moment when the athlete slightly opened his mouth, relaxing the jaw muscles, or did not have time to absorb the blow by moving his head. Having received this injury, the fighter will no longer be able to continue the fight and the victory by technical knockout will be awarded to his opponent.

The moment of bone fracture can be easily distinguished from another injury by its internal state. At this moment, the rapidly running time suddenly slows down, and you clearly hear the crunch of a breaking bone. There is intense pain, limitation of movement of the limb, or vice versa, pathological mobility (where it should not be) at the site of the fracture, the shape and length of the limb may be disturbed in comparison with the healthy one.
When giving first aid to yourself or another person, you need to be extremely careful not to harm or cause more pain. First, you need to stop bleeding (if any), anesthetize, if there is a wound, apply a bandage and provide transport immobilization.
Transport immobilization is the creation of immobility of the injured limb for the time required to transport the patient to the hospital. For immobilization, service tires are used, which can be made from improvised means.The splint is applied, capturing at least two adjacent joints.
The main task of immobilization is to prevent further damage to the soft tissues, blood vessels and nerves surrounding the fracture site with bone fragments. This reduces the risk of developing traumatic shock, significant blood loss and infectious complications.
The complexity of the fracture is determined by the X-ray at the hospital. Then the bone is set and a plaster cast is applied. Sometimes an operation may be necessary, in which the fragments of the bones are connected using special metal parts.
After removing the plaster, massage, therapeutic exercises and physiotherapy are used to shorten the recovery period.
In my life, I have not been able to avoid fractures: in training, playing football, I broke the talus on my right leg, and during a street fight from an unsuccessful blow I broke the fifth metacarpal bone on my right hand. With a broken leg, I did not immediately realize the seriousness of the injury. I thought that when any bone on the leg is broken, a person loses the ability to step on the injured limb.And I seemed to be able to move independently. Therefore, without showing pain, I continued to train and prepare for the upcoming competition. True, I had to apply a tight bandage and rub the injury with warming ointments. And only a week later, I suspected something was wrong and went to the emergency room. And then a painful month awaited me in a knee-deep cast))
I wish you never to break anything for yourself. Be careful, extra caution will not hurt!

Boxer fracture (fifth metacarpal bone)

Fracture of the fifth metacarpal bone with displacement – violation of the integrity of the bone with complete or partial damage and concomitant articular displacement.This injury is also referred to as a “boxer’s fracture,” as it often occurs as a result of a strong blow.

Characteristics of the injury and its causes

The fifth metacarpal bone has a curved shape and is directly involved in the process of flexion and extension of the fingers, gripping objects. Fracture 5 of the bone can have the following varieties:

• Open.
• Closed.
• Splined.
• Offset.
• No offset.

Boxing fractures with displacement, in which there is a shift of bone fragments, according to traumatologists, are considered the most dangerous and difficult.

The following factors can provoke this damage:

1. Injuries.
2. Blows.
3. Presence of intraosseous tumor neoplasm that weakens the structure of bone tissue.
4. A fall on the fist or a strong blow with a fist.

According to statistics, this type of traumatic injury occurs in 40% of cases. Moreover, representatives of the stronger sex are faced with such an injury almost three times more often than women. The fifth metacarpal bone can break and shift when practicing traumatic sports such as karate, boxing, wrestling, basketball, volleyball, etc.

How is it manifested?

Fracture of the fifth metacarpal bone is characterized by severe pain syndrome that occurs immediately after the injury.At the same time, there is a clear tendency towards increased pain when trying to make any movements with the fingers. In addition, the victims have the following characteristic clinical symptoms:

• Deformation, retraction of the head of the 5th metacarpal bone.
• Pathological mobility with finger movements.
• Puffiness.
• Hemorrhage, hematomas.
• Shortening the finger.
• The appearance of a specific crunch.
• Modifies the brush path.

Patients also have a noticeably weakened grasping function, they cannot clench their hand into a fist and experience acute, unbearable pain during such attempts. If such symptoms are detected, it is necessary to take the victim to the emergency room as soon as possible, where he will be provided with qualified medical care, since this kind of injury often entails very serious consequences.

Possible complications

If a person with a “boxer’s fracture” was not provided with timely assistance or treatment was not complete, then the following extremely undesirable complications are likely to develop:

• Damage to collateral ligaments.
• Incorrect position of bone fragments with concomitant asymmetry.
• Disorders of the extensor mechanism.
• Injury of the extensor tendon.
• Peripheral offset.
• Toe deformation.

With open fractures, as a result of infection, abscesses, suppuration, and sepsis may develop. As a result, the patient may completely lose the ability to work normally, move the injured limb. Fortunately, the achievements of modern medicine, with timely access to a specialist and adherence to all medical recommendations, make it possible to avoid the development of such undesirable consequences.

How to help a victim?

First aid presupposes mandatory immobilization, and the sooner this is done, the better. The injured limb should be fixed in a stable position with a splint (you can use any available means, for example, a plank or a folded magazine), so that the hand is slightly unbent and the fingers are in a bent state.After that, you should bandage your hand or hang it on a scarf.

In case of an open fracture, it is necessary to start by stopping the bleeding and treating the wound surface with an antiseptic, as well as applying a sterile dressing to prevent further infection.

In order to eliminate puffiness and alleviate the condition of the victim, cold, ice compress, ice heater are applied to the affected area. With severe pain, you can give the person a pain reliever to drink.

Do not try to self-medicate, as in this case it is very dangerous! Try to take the victim to the trauma department of the hospital as soon as possible for diagnostics and subsequent treatment!

If you do not consult a specialist, further aggravation of the traumatic injury, improper fusion of bone fragments, is possible. In such cases, a very unpleasant and painful procedure awaits patients – breaking bones, followed by the application of a plaster cast or surgery! Moreover, the positive outcome of such procedures cannot be guaranteed, there is always a serious likelihood of disability, so it is better to be vigilant and not risk your health!

Diagnostic methods

Diagnosis of a fifth metacarpal bone fracture begins with an examination of the victim by a doctor – surgeon or traumatologist.As a rule, it is not difficult for an experienced specialist to deduce the nature of the injury.

However, in order to make an accurate diagnosis and determine the type of fracture, patients are assigned a mandatory X-ray examination, which allows to identify all possible chips and displacements. The X-ray is taken in three projections.

In cases of intra-articular, multi-splintered fracture, computed tomography or magnetic resonance imaging may be recommended.

Methods of conservative treatment

All therapeutic measures in case of a fracture of the 5th metacarpal bone, first of all, should be aimed at restoring the integrity of the bone tissue, its normal functioning and physiological position. Any manipulations are carried out exclusively under the influence of local anesthesia, since, otherwise, there is a high probability of pain shock.

In simple clinical cases, conservative treatment is preferred.The specialist, by pressing on the back of the wrist side, directs the displaced bone fragment to the correct physiological position, after which he fixes the limb, applies a plaster of Paris to the hand. A few weeks later, a repeated X-ray examination is performed, which allows tracking the dynamics, the process of fracture healing.

Surgical treatment

Surgical methods of treatment are prescribed for complicated displaced fractures and involve hospitalization of the victim.During the operation, a special needle is inserted through the patient’s nail phalanx, which facilitates skeletal traction of the debris.

In the most severe cases, surgery is performed under general anesthesia. The hand is cut, the bone fragments are reduced and compared. The specialist gives the hand and fingers the correct position, after which the needle is inserted. At the end of the operation, sutures and a fixing plaster cast are applied.

Rehabilitation period

Rehabilitation after a fracture of the fifth metacarpal bone assumes maximum limitation of motor activity, often patients are prescribed anti-inflammatory, analgesic medications, chondroprotectors, vitamin-mineral complexes, calcium.

Further rehabilitation measures aimed at the functional restoration of the damaged bone begin, as a rule, after the removal of the cast (approximately 4–6 weeks after the injury).

The following physiotherapy procedures are recommended for patients:

• Magnetotherapy.
• UHF therapy.
• Warming up with a blue lamp.

Physiotherapy exercises are of great importance.In addition, patients are advised to regularly perform a special set of exercises aimed at developing motor activity and fine motor skills. Here’s what to do during the rehabilitation period:

1. Fiddling with croup.
2. Collection of models from the children’s designer.
3. Performing circular movements with the hand and fingers.
4. Fist clenching.
5. Exercises with an expander.

Such classes should be carried out regularly and systematically, from three to five times throughout the day.

The duration of the rehabilitation period depends on many factors, such as the severity of the injury, the nature of the fracture, the method of treatment, age and individual characteristics of the patient. On average, recovery lasts 2-3 months.

About prevention

Prevention of “boxer’s fractures” consists in maximum caution and compliance with safety rules during sports training, competitions, lifting weights. Professional athletes and people involved in heavy physical work who are in a high potential risk group are advised to regularly do special exercises that strengthen their hands, take calcium supplements, vitamins that help increase bone strength.

Boxing fracture is a fairly severe and widespread injury. In order to avoid numerous adverse consequences, it is important to competently provide the victim with first aid and deliver him to the emergency room as soon as possible.

Treatment is carried out by both conservative and surgical methods, and is selected by a specialist individually, depending on the nature of the injury. In the case of a timely visit to a doctor, competent treatment and rehabilitation, the medical prognosis for this type of traumatic injury is considered quite favorable.

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90,000 Typical Boxer Injuries and First Aid Measures

We continue to publish German information sources. We bring to your attention an important, in our opinion, article on typical injuries in boxing and on the protection of boxers’ health.

Professionals at risk

Typical boxers’ injuries include facial injuries, muscle sprains, and bruises.

A professional boxer often has to pay for his career with health and undergo rehabilitation measures in order to minimize the consequences of various injuries.

Typical injuries associated with professional boxing include:

• eyebrow dissection;
• dislocations of the shoulder;
• bruises of the liver;
• fractures of the wrists;
• fractures of the nose.

Practically in these injuries, it is very important to provide prompt assistance, therefore professional doctors should always be present at the competition.

Dissection of the eyebrow

This seemingly minor injury can have large negative consequences. During the fight, severe bleeding can occur, which obscures the eyes. Emergency medical attention is needed to stop the bleeding.

In the future, improper (without supervision by doctors) healing can lead to the fact that the eyelid (eyelids) will not fully open (close) or some other deformation will occur. This must be taken very seriously.There are cases when improper treatment even led to blindness.

First aid measures for eyebrow dissection

To stop bleeding and provide first aid, it is necessary to clean the wound with a swab moistened with water or a special compound. Chill it with ice or a refrigerated appliance. Apply a bandage with a special cooling (healing) ointment or other similar medications.

In the future, depending on the severity of the wound, either sutures or a healing bandage will be applied.

If the cut is minor, the fight can be continued.

Dislocation of the shoulder

A dislocation of the shoulder usually occurs when a fighter falls on a bent or bent arm. Such an injury requires an immediate stop of the fight.

And prompt medical assistance.

First aid measures for shoulder dislocation

The very first measure is to put the dislocated shoulder back on the battlefield. Since the procedure is painful, it is performed with anesthesia.Or the consequences of the injury are treated in a medical facility. Rehabilitation measures are underway. A pause in boxing is required, which, as a rule, is up to three months.

In no case is it allowed to set the joint on your own, as this leads to additional injuries and complications.

Achilles’ heel

Liver kick is one of the most common in boxing. With the help of such a blow, you can bring your opponent to his knees, literally and figuratively.The liver is a boxer’s Achilles heel.

In other words, the liver is a very sensitive organ and a blow to this area is monstrously painful. In addition to the pain itself, this leads to a decrease in blood pressure, immediately there are problems with blood vessels, a boxer has black circles in front of his eyes … And he can no longer continue the fight. Technical knockout counts.

If pain is felt after a while with a bruised liver, see a doctor.

Fracture of the wrist

This is one of the most common occurrences in boxing, although the hands are protected by gloves. Since the fight produces a lot of stress hormones that dull pain, the fighter may not even feel the trauma. A fractured wrist is not a reason for canceling the fight if the boxer states that he can continue to fight.

First aid measures for a fractured wrist

The battle is over and it is necessary to immediately provide treatment for this injury.Treatment depends on whether the fracture is closed or open. If the fracture is buried, then plaster cast is sufficient. An open fracture may require surgery.

After rehabilitation, the boxer must spare the injured hand for two months.

Fracture of the nose

Another typical injury in boxers is a broken nose. This is the most sensitive and fragile part of the facial region.

Fracture of the nose occurs mainly by direct blows into it, which leads to the destruction of the nasal septum.Most boxers do not notice or pay attention to this injury during the fight.

If the nose bleeds, then in the interval between rounds it is stopped with the help of tampons moistened with special compounds.

Nose fractures for boxers, a kind of “work injury” or even “occupational disease”.

However, the negative consequences should not be belittled. In particular, breathing may be difficult due to improper fusion, the nose may be significantly curved.Therefore, rehabilitation measures should be carried out under the supervision of specialists. Many boxers, after completing their careers, seek the services of plastic surgeons.

The injuries described above can also affect amateur boxers, especially if their amateur level is high enough. Therefore, you should not rely “at random”, but take good care of your health.

Low injury risk at the Alexander Morozov Boxing School.

Phone : +7 (812) 930 23 98

Address : St. St. Petersburg, metro Bukharestskaya, st. Salova, 52 / st. Sofiyskaya, 4, bldg. 3

90,000 Broken paw in a dog, what to do? How to treat?

First of all, find out what this fracture is. And whether you need operative (surgical) or conservative (non-surgical) care.
The fracture may be mechanical (the effect of a mechanical factor). The most common cases: a cat fell from a height, a dog was hit by a car, etc.
And pathological (structural changes and weakness of bone tissue).Most often, this type of fracture occurs with tumors in the bones, childhood rickets, senile osteoporosis, prolonged inflammation in the bones (osteomyelitis), etc.

The methodology for treating bone fractures in dogs and cats is similar in many ways. In this text, we will describe treatment regimens primarily for dogs, but they all apply to cats and other species of animals.

It seems that the gracefulness, flexibility, plasticity of dogs makes them invulnerable in everyday life, when they run and jump, engage in training with their owners.For a dog to hurt its paws, spine, hurt its head, it is not necessary to hit it with a car. The animal can simply slip and land unsuccessfully, turn around, collide with an obstacle and get injured.

Causes of injury

Fracture of a paw in a dog occurs for many reasons:
 fragility of bones in artificially bred animals. Purebred dogs are valued much higher than ordinary animals, but they lose their health. Therefore, it is not necessary for the dog to be hit by a car, it can simply jump off the couch unsuccessfully, and you are already asking yourself the question: the dog has a broken paw, what to do?
 most often animals are hit by vehicles;
 dogs fall from a height;
 a fight with rivals;
 people were beaten;
 pathology.

Signs of fracture

The most obvious sign is that the animal is behaving strangely. It cannot step on a paw, howls with pain, with a closed fracture, swelling immediately forms. It is impossible not to notice an open fracture. The animal cannot straighten its paw, it hurts to touch the sore spot. Even worse is a comminuted fracture when you hear the bones crunch.

The main signs of a paw fracture in dogs:
 cracks – carefully examine the paw, the animal is in pain, but even a little active.It is important not to confuse it with a bruise, since in the latter case there is swelling. And the crack touches only the bone, so there is no edema, the soft tissues are intact;
 fragments of bones enter each other, the animal is limping, soft tissues are in a normal state, there is no swelling, but the broken limb is shorter than healthy legs;
 bones are not displaced, but the painful area is reddened, slight swelling. With a closed fracture, the dog cannot stand on its paw, it hurts, the behavior is aggressive;
 bones are displaced relative to each other.The animal whines, licks the damaged area. There are hematomas, soft tissues are badly damaged;
• with an open fracture, the bones stick out. Often, blood vessels are also damaged, so there is bleeding. The main thing is not to be intimidated and deliver the dog to the veterinary hospital on time.

First aid

Help is needed only if a dog has an open paw fracture. Blood vessels can be damaged by sharp bone fragments. It is important to stop the bleeding and get your dog to a doctor. They stop the blood like this – with a handkerchief, rope, everything that is at hand, bandage the paw above the wound and bandage it tightly.The wound should not be touched in any case. Bandage the place above the wound. If there is a tourniquet, it is best to use it to stop the blood. But under it must be placed a napkin, cloth, scarf, so as not to damage the skin. It is advisable to fix the injured limb in order to limit mobility as much as possible. This is not bone reduction. The less the dog will put stress on the sore paw, the less harm it will cause to itself. The paw is tied to a wooden board, plywood, so that the dog is motionless.If you cannot cope with this on your own – you do not have the necessary materials at hand, you are afraid that you will harm the dog, it is better not to touch anything. Just stop the blood and take the dog to the surgeon immediately.

Treatment of leg fractures

The examination begins with the administration of painkillers. The doctor examines the patient and prescribes the necessary examinations. As a rule, this is an X-ray, ultrasound. Perhaps not only the limb is damaged, because if it gets into an accident, the dog’s internal organs, traumatic brain injury, etc.can be damaged.d.

Almost all types of paw fractures in a dog require surgery. Applying only plaster is not enough. Natural self-preservation allows animals to emerge victorious from many dangerous situations. Therefore, if a dog ends up in a veterinary hospital, then things are bad. Usually always an open fracture. And in this case, bones are collected, tissues are sewn together. Gypsum will not keep an animal from trying to get rid of it. The dog will still try to walk more, so it can hurt itself.Bones heal best when all the fragments are clearly fixed, when they are correctly assembled. It is impossible to achieve all this with plaster cast alone, an operation is needed.

Transaction types

The most common types of surgery:
– INTRAMEDULAR OSTEOSYNTHESIS. Intraosseous stabilization of fragments with long metal rods: pins, needles, nails, etc. It is widely used in veterinary practice. This is due to the relative ease of operations: no special equipment is required, the materials themselves, implants, are quite affordable and cheap.BUT! This method has many limitations. First: the stabilization of bone fragments is not always satisfactory; secondly: the transosseous conduction of the metal is a little anatomical; third: the animal does not immediately use the limb. Therefore, the methods of intramedullary osteosynthesis are used by us, in total, no more than 30% of cases.
– PASTE OSTEOSYNTHESIS. Dense and anatomical fixation of fracture fragments using metal plates. For comminuted fractures – often an irreplaceable method.And its main advantage is early functional loading. The animal begins to walk on a broken leg immediately after surgery. And this is one of the components of success. The method is used often, in about 50% of cases.
– EXTRA FOCUS OSTEOSYNTHESIS. External fixation devices. Their main “plus” is the possibility of closed correction of the fracture during fusion. But there are also “disadvantages” – this is a more laborious postoperative period for the owners of the animal and the constant possibility of infection. The method is used by us in no more than 20% of the total number of cases.

Conservative help. Non-surgical treatment of fractures. The methods are mainly represented by options for applying support and immobilizing bandages (plaster cast). By the way, mineral gypsum is now almost completely replaced by synthetic thermoplastic polymers. Conservative treatment is successful for very simple, closed fractures of the hand, forearm, and foot. In general, plaster (plastic) is used relatively rarely in animals for fractures. Of the total mass, the application of plaster splints is effective for fractures of the “green branch” type.This is when the bone is bent rather than broken.

There are several techniques in each technique. So there are many treatment options for bone fractures. For clarity, this section will consist entirely of photographs, X-rays and explanations to them.

External osteosynthesis. Fixation of bone fragments and their fragments using plates – straight, curly, with limited contact, with angular stabilization, reinforced, etc. We have to collect fractures with plates very often.This is a good method. Even if the plate is less strong than a pin or a nail, it is more anatomical, which ultimately affects the quality of the fusion.

Diaphyseal oblique comminuted fracture of the leg bones. Drathaar. 10 years. Trauma. Overlaid titanium plate with limited contact. Supplement with cerclages. The photo shows the patient 4 days after the operation. Uses a limb. (Early functional loading is one of the components of successful bone fusion).

The plate must be strong enough to take all the load from the limb onto itself.An incorrectly sized plate can break. The calculation of the length and thickness of the plate is done in each case of using bone osteosynthesis. It is also important to determine the dynamic strength of the bone itself, so that the screws screwed into the bone are well retained in it.

Dogs of miniature breeds (Yorkie, Toy, Chi-hua-hua, etc.) have a weak spot in the peripheral skeleton – the lower third of the forearm. Very often, a fracture on the front paws occurs in this place.Moreover, to obtain a fracture, sometimes very insignificant loads are required. Often, a simple jump from the couch or from the hands leads to a fracture of the front paw.
The images show a fracture of the bones of the forearm, a plate has been placed. Before the paw had time to heal, a similar fracture occurred on the other paw. Now the plates are on both limbs and, possibly due to the fragility of the bones, they will be left for a long period of time or for life. These plates do not cause discomfort and are lightweight. The animal can calmly live and move with them.But, only on condition that they have taken root and are not rejected by the body. Rejection of foreign material is rare, but it does happen.

Here is the same fracture of the lower third of the forearm bones, only in a large dog. It happened as a result of a car injury. People often have such fractures when falling from roller skates or from a bicycle; doctors sometimes jokingly call them “spring fractures.”
A sufficiently powerful plate is installed here, because it must take on not only axial, but also lateral loads. Such plates are removed after 1.5 – 2 months.

Bone osteosynthesis for fracture of the tibia in a raccoon. The fracture occurred as a result of the fall of the beast from the 8th floor. In the first, preoperative picture, damage to the pelvic bones is also visible. A sufficiently strong plate was imposed on the fracture of the lower leg, because the beast is strong, wild and will not take care of the limb until the moment of fusion. In such cases, a deliberately increased structural strength is required.
Why, then, does everyone not put reinforced variants? The fact is that the thicker and stronger the plate, the more it weighs.That is, it has an increased volume and mass, which can also negatively affect the quality of the splicing. All techniques have their limits.

For comminuted fractures, compression plates are applied. The screws in such plates are installed at angles to the bone. This achieves a tight compression of the bone fragments. This method is called “compression-distraction”. Its purpose is to eliminate the slightest instability between the fragments. Immobility of bones in the area of ​​their fusion is the main condition for success in complex fractures.

Of course, plates, especially those located subcutaneously, can sometimes cause some concern to their owner. In the photo: the plate applied for the fracture of the foot began to “cut through” the skin after 2 months. Screws are visible through the wool (indicated by arrows). This happened as a result of the cat’s intense licking of the fracture site.
This is not a big deal, but it requires removing the plate. For social reasons (worried). All bones healed well.

Intramedullary osteosynthesis, intraosseous stabilization, IMOS.It is used less frequently than bone synthesis. The method is often more durable than plate assembly of fractures, but it is also less anatomical. Nevertheless, there are cases when IMOS is indispensable.

Intramedullary osteosynthesis of oblique non-splintered epiphyseal femur fracture at 2 months. kitten (the place of the fracture is indicated by an arrow). Stabilization with a Bogdanov nail. A closed technique was applied. That is, the nail was carried out without incisions in the skin and access to the fracture site.
In this case, this is the method of choice, since the patient is still very young and his bones are thin and weak. No screws or knitting needles can hold such bones.

Combined method.
Plating for a multislice fracture of the tibia in a cat + intramedullary osteosynthesis.
In this case, the plate acts as a fixation of the fragments, and the main load is taken by the rod inside the bone.
Shin fractures are some of the most difficult fractures in the peripheral skeleton.A very precise and firm reduction is required to avoid instability and rotation. Fragments of the damaged bone with the help of the plate are “pressed” into each other and fixed.
With these techniques, you can and should start walking immediately after the operation.

Intramedullary osteosynthesis of the radius. Postoperative radiographic view. High contact and strength. But we do not use such techniques very often. The fact is that the needle in this position injures the wrist joint somewhat.Therefore, it should be removed as soon as possible. Yorkshire Terrier. 1 year. Falling from hands.

If necessary, polymer splints are applied to the extremities for the period of fusion. They enhance the stability of the fracture under stress.

Bilateral intramedullary synthesis of the femur. High-altitude injury. the cat fell from the 10th floor. The result is multiple fractures of the limbs and soft tissue injuries. On x-rays, dark lesions are visible in the soft tissues of the thigh.These are cavities resulting from extensive ruptures of tissues – muscles, tendons, blood vessels, etc.
When the patient was admitted to the clinic, he was diagnosed with severe hemodynamic disorders of the extremities. Making wide incisions in the skin and muscles to access fractures and insert plates was dangerous in this situation. But, it is also impossible to leave fractured bones in an unstabilized state. Therefore, the choice of the technique in this case fell on IMOS.

Distal epiphyseal fracture of the femur, bilateral.Such fractures occur mainly in young animals under one year old. Their bone growth zones have not yet been closed – these are areas due to which the bone grows and lengthens. There are many immature bone cells in the growth zones, due to which the growth zone is a focal structural softening, that is, it consists, as it were, of semi-cartilage. In these places, the bone is most vulnerable to displacement and fracture.
The first photo shows a preoperative picture. The thigh bones are “stumps” (indicated by arrows), then there should have been a knee joint, but it is broken off.In this case, it is not possible to attach a small and still soft joint to the bone using plates. And here again IMOS comes to the rescue. The synthesis is made using steel spokes. The prognosis is favorable. Due to non-closed growth zones, fusion occurs very quickly and firmly.

In necessary cases, for example, with multi-splinter fractures, wire cerclages are applied to the bone. In the photo, they are visible in the form of rings. But in general, if possible, they should be avoided overlapping.The thing is, they are very difficult to take off. They can literally “grow” into the bone, violating its trophism and strength.

Fracture of three toes on the hind paw of a cat. Falling from the 11th floor. Despite the frightening appearance, this type of fracture is not dangerous. Due to the low functional load on the foot, in animals, full recovery is ahead. A closed connection of the fragments and the imposition of an external splint or plaster is sufficient. No signs of discomfort or lameness in the projections.

Fracture of the shin in a chinchilla. Despite the technical possibility of connecting bones using IMOS, there is one problem. Namely: the high risk of aseptic necrosis of bone tissue with open surgical techniques. In other words, the bone, even with a good connection of the fragments, may not grow together and even dissolve due to hemodynamic disturbances.
Vessels in the limbs of small animals, such as chinchillas, mice, rats, squirrels, etc., are also very small and thin, and are easily damaged at the time of fracture.But even if the blood supply to the limb after the fracture remains at a satisfactory level, it can be completely disrupted after surgical access to the bone. The incision of soft tissues for access to the fracture site leads to injury to the vessels and capillaries, which, as a result, can lead to a lack of blood supply to the limb. Deficiency of blood supply can cause unsatisfactory union of the fracture, dissolution of bones and even, in severe cases, to the death of a limb. The danger of a shortage of blood supply is the higher, the lower the fracture site is from the body.That is, the risk of deficiency is higher on the lower leg than on the thigh.
If IMOS is the only option for such fractures, then it is performed in a closed way. That is, without surgical access, by introducing a wire through the skin under X-ray control.

Pathological fracture of the calcaneus as a result of osteoporosis. The calcaneus in this state is a loose bone semi-collapsed structure, which is useless to restore. The only way out in this situation is transposition of the Achilles tendon, to preserve the functionality of the limb.

In the event of a break or transposition of the Achilles tendon, long-term immobilization of the hock is required. One of the options for creating immobility of the joint is shown in the photo. Temporary immobility of the joint is required for successful tendon fusion, which takes at least 6 weeks.

There are situations when you have to deliberately saw bones and connect them in a new way to give them new configurations. Such techniques, for example, eliminate hallux valgus or change the plateau of the tibia (pictured).
These operations are performed when the anterior cruciate ligament of the knee is torn. Their purpose is to change the inclination of the joint in such a way as to relieve the ligamentous apparatus. To do this, a wedge is cut out of the tibia and the bones are reconnected with the optimal arrangement of the articular surfaces. Before the operation, all parts of the joint are carefully measured to determine the angle and distance to which the plateau of the tibia should be displaced.

There are situations when bones grow together on their own after seemingly complex fractures.Here’s an example: once a homeless dog (pictured) came to our appointment, active, no lameness. Complaints – not overgrowing fistula on the back of the thigh. This happens when there is a foreign object in the thickness of tissues, for example, a bullet. X-rays were taken. According to the picture, a rather large fragment of a femur turned out to be a foreign object! He turned out to be “superfluous” in the fracture fusion. It is surprising that a rather complex hip fracture in 2 places healed independently, crookedly, but of sufficient quality. Even the length of the bone was not affected! We just have to extract the extra bone fragment and that’s it (in the photo below).

Extrafocal osteosynthesis.

Devices for external fixation. The method is also represented by a wide variety of techniques.

Ilizarov apparatus, KUD-SAI apparatus and other rod means of external compression-distraction fixation.
Their main advantage is the ability to compress or stretch bone fragments at different periods of fusion. That allows you to eliminate deformities and carry out skeletal traction with defects in the length of the bone. But with all the advantages, these devices can be quite cumbersome, which limits their use in veterinary practice in small animals.

Much more often, extrafocal synthesis in small animals is carried out with the help of pins fixed from the outside with self-curing plastic (in the photo there is an X-ray view). This method of immobilization without the possibility of correction is a disadvantage. But the whole design is very light – this is a plus. The poles also include the possibility of long-term wearing of the structure and the possibility of its removal without anesthesia.

From the outside, extrafocal synthesis on plastic looks like sticks, parallel to the paw, but not touching its skin.

Extrafocal synthesis in case of jaw fracture.
It happens that with multifocal fractures of the lower jaw, this method of assembly is the only solution to the problem. Despite the seeming bulkiness of the external “bumper”, it is well tolerated by animals. It is allowed to take food with such a design immediately after the operation.

There are situations when the only way out is to delete. This happens with purulent-septic or hemodynamic lesions, accompanied by deep tissue destruction. Or in case of technical impossibility of recovery. Or with cancer of the bone tissue. Or as a consequence of a traumatic amputation.
In the photo: a kitten whose front limb had to be removed for several reasons. He, a former resident of the basement, hit a rat trap with his paw.As a result of the chopping injury, part of his paw was almost torn off. Further it gets worse. Gangrene began. To free himself from captivity, the kitten bit off its already insensitive paw, but the purulent-septic lesions began to rise higher along the rest of the limb. Everything could have ended in sepsis and death. But kind people picked up this kitten and brought him to the clinic. At the time of admission, the paw was almost completely destroyed. I had to perform a high limb amputation. It is clear that in this situation it was the only way out.The second photo shows a patient after surgery. Now he has a home and loving owners.
Despite the radical nature of the techniques, amputation and disarticulation have many options. And they require strict rules for their implementation. An incorrectly performed operation can only cause harm in this situation.

Of course, it is not possible to talk about all the methods and techniques for treating skeletal injury on the pages of the site, so let’s move on to individual cases.

Generalized osteochondrosis.The vertebrae are motionlessly fused with osteophytes. Neurological disorders. Boxer 14 years old. Such diseases are also the work of a trauma surgeon.

An old (about a year old) bullet wound in the fore paw of a cat. There was septic inflammation at the site of the injury for a long time. The picture shows a foreign object in the tissues of the paw and an incipient bone tumor. Taking into account the possible malignancy of the process, an urgent operation was performed – removal of the object and resection of a bone fragment with cancer.The finiteness and its functions are preserved.

Bilateral intra-articular fracture of the hock joints. External reinforcement with thermoplastic. Joint immobilization for 30 days.

The term “intra-articular fracture” is often misused. Here is a dislocation of the wrist joint on the X-ray, although it looks like a fracture. This type of dislocation can be successfully repaired without surgery. But, of course, not in all cases. Sometimes a full-fledged joint stabilization operation is required.

Here is a complete fracture of the radius at the level of the elbow joint + intercondylar fracture of the humerus. This can be attributed to intra-articular fractures.

Dislocation of the shoulder joint with destruction of the glenoid cavity of the scapula.

Intra-articular fracture of the elbow.

Osteosarcoma of the distal epiphysis of the humerus. Despite the radiopaque appearance and apparent density, this neoplasm destroys the bone, which ultimately leads to a pathological fracture.

Rehabilitation of a dog with a broken paw

Literally a day after the operation, the dog will be at home. The risk of postoperative complications is minimal. When a dog has a broken paw, it needs rest, for the entire period of fusion. Inactivity in this case is fraught with obesity, so the animal has a balanced diet. The owner gives the dog pain medications, treats the stitches, pampers with vitamins and other useful additives that the veterinarian will prescribe. After all, the bone needs to heal well and quickly.After a week, the dog will already walk, leaning on its paw. Full recovery occurs in 3-5 weeks. It is important that during this period the animal is not overworked, and physical activity is under control.

Doctor of Veterinary Medicine M. Shelyakov

Fracture of the fifth metacarpal bone (boxer’s fracture)

Last Updated on 05.07.2017 by Perelomanet

The human skeleton has a mass of small and large bones.The hand is formed by small tubular bone tissues that perform special functions, which include the metacarpal bones (metacarpal). They participate in the process of flexion-extension of the fingers and have curved shapes.

There are 5 small short bones in the palm of a person, in the area between the lower edge of the fingers and the wrist. Their numbering is similar to the serial number of the finger with which they are associated and starts from the side of the thumb.

The metacarpal bone is conventionally divided into base, head and body.By thickened bases, they are connected to each other and to the nearby bones of the wrist. The head is in the form of a ball with a slight bulge in the palmar part.

Types of injuries, their causes

Injury occurs as a result of an unsuccessful blow with a fist on a hard object or when falling on a wrist, an open palm, when the palm is pinched between two objects. It is often referred to as the “boxing fracture” because associated with this sport. Despite the small size of the bone, fractures are distinguished by the localization of the focus.Injuries Happen:

• at the base;
• in the center;
• on the head of the bone.

Among the most common types of metacarpal fractures, the following are recognized:

• open, closed or comminuted fractures,
• with or without offset;
• single or multiple formation of fragments;
• oblique, angular, rotational, helical damage contours.

The most difficult and dangerous is considered a fracture of the fifth metacarpal bone with displacement or comminuted injury.

Depending on the type of fracture, the appropriate treatment methods are prescribed.

Symptoms

Fracture of a boxer is observed:

• Acute pain, aggravated by movement of the hand or fingers;
• swelling;
• changing the outline of the brush;
• bone deformity, distinguishable on palpation;
• specific sound (crunch) when moving;
• mobility in unnatural places;
• Appearance of hematomas
• inability to fold the palm into a fist.

First aid

Emergency care for a fracture of the 5th metacarpal bone includes a number of measures to fully restore the functions of the hand. The patient’s subsequent life depends on its quality and accuracy.

Delivery stages:

• hand immobilization. The injured person must abandon movements that involve the metacarpal bones;

90,083 taking painkillers;

• to reduce the hematomas formed during trauma, cold is applied to its site.

Having provided a patient with emergency care, it is necessary to transfer him to the reliable hands of doctors. With the use of modern diagnostic tools, a traumatologist will be able to establish an accurate diagnosis and prescribe treatment.

In some cases, the patient may need surgery. This occurs with complex fractures with displacement or comminuted, multiple formations of fragments. In some cases, the displaced fragment is set using a closed method under local anesthesia.

Immobilization of the patient at the first stage can be carried out using available means. A magazine, book, or board of the appropriate size is suitable for this. The injured hand itself is in an extended position, and the fingers are slightly bent. In this position, the hand is bandaged to an imaginary tire and secured to a kerchief, scarf, etc.

In case of an open fracture, it is important to provide the patient with important anti-inflammatory and disinfectant procedures – to treat the wound, stop blood loss, apply a sterile bandage to prevent dirt, dust, bacteria, and small foreign bodies from entering.

Treatment

Like all fractures, metacarpal injuries require two treatments. The conservative method is used for uncomplicated trauma, and consists in applying a plaster cast to the patient. Gypsum is removed after 4-6 weeks after the injury and this is done only after additional, intermediate radiography. This is necessary to exclude a re-fracture, complicated, in some cases, by displacement.

Surgical intervention is necessary for the tight connection of the fracture fragments when they are in an incomparable position and cannot heal properly without the help of a surgeon.The doctor determines the need to remove fragments, cleaning soft tissues from small fragments.

Applied osteosynthesis implies an operation with fixation of fragments using auxiliary means – pins, screws, plates. This is necessary in cases where the bone has shifted, a shift in width or length is noticeable, as well as its deformation at an angle.

In case of a fracture of the central part of the bone, pins are used that are installed inside the bone. The pin is inserted into the medullary canal and left for 4-6 weeks, then a foreign object is removed based on the results of diagnostics indicating complete fusion of bone tissues.

In some cases, fixing pins are used to connect the damaged bone. They are brought to the site of injury through punctures in the skin. Their edges protrude from under the skin or are completely submerged under it. The needles are removed after the fracture has completely healed, after a 6-week term.

Some aids are removed after a year after injury or remain in the human body for life.

The doctor is busy with determining the method of fixation and the need for an operation.Based on the indications and features of the displacement of the fragment, one of the methods of osteosynthesis is selected. With severe pain felt by the patient at various stages of bone healing, analgesics are used. Their dosage is determined based on indicators of pain intensity.

Rehabilitation

After removing the plaster, the patient feels some discomfort and stiffness in the movements of the hand and fingers. During this period, he needs a special set of measures for complete recovery and normalization of the functioning of the limb, its full return to the physiological position.

One of the components of the complex is special exercises of physiotherapy exercises, which are individually selected for a certain type of injury and age characteristics of the patient’s body, his general state of health.

As a rule, a few days after the operation, mobility in the joints of the hand begins to resume. During this period, the patient begins to move his fingers. This is necessary to exclude violations of the physiological functions of the limb. The developed set of exercises under the supervision of a rehabilitation therapist, selected by him exclusively for a specific patient, will help to cope with the trauma.

Nutrition of the patient is an important factor in the treatment of any fracture and during the rehabilitation period. Calcium-containing products are fundamental at all stages of bone tissue fusion. A pharmacy vitamin complex, which includes all the necessary trace elements, should be in the diet of everyone who has received a fracture.

Consequences

Like other fractures, injuries to the 5th metacarpal bone can have complications and serious consequences.They, as a rule, arise when the patient treats the doctor’s prescriptions with negligence or is ignored by visits to doctors. This is fraught with improper healing of the fracture, which may be caused by a lack of diagnosis at the initial stage or due to excessive loads on the injured arm. The result of a closed injury can be pathological deformation of the bone, disruption of the normal functioning of the limb.

With an open fracture, infection may occur and, as a result, the formation of suppurations and abscesses.

Prevention

The best prevention of fractures is through careful personal precautions, adherence to safety rules, and control of physical activity associated with lifting weights or playing sports.

For professional athletes or those who are engaged in heavy physical labor, daily training of the hands, the use of vitamins containing elements that strengthen bones are necessary.

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