Joe A Shaw PA-C - 12/16/2011

Question

distal metacarpal   Hi,

I recently received a boxer's fracture of my distal metacarpal in my right hand.  I got x-rays and the doctor said there is mild angulation. The injury is a few weeks old now so I know that the healing process is well underway.  I feel that if I was to take further steps to fix it, I would have to re-break the bone.

I know this is hard to discuss without seeing the x-rays, but I am wondering about the long-term consequences about not attending to the injury. I ask because I don't have insurance so the procedure would come out of pocket. I am a college student and work full time, but I most likely couldn't afford the procedure.

The doctor told me that if I let it heal that it will be deformed, but may eventually be somewhat normal.  It was a doc-in-a-box, so she couldn't really explain much more than that.

I don't mind having a bump on my hand, but I use boxing as my exercise to keep me in shape, and I'm concerned that continuing to box after my hand heals(heals with the angulation) will cause excessive damage, or will all together prevent me from boxing at all. I don't have aspirations to be a professional boxer or anything, but I enjoy the training and occasional fights.

So, what do ya think? With the limited information, will the mild angulation left unfixed prevent me from continuing boxing? I will give it plenty of time to heal before I even consider getting back into training, but I just want to know if letting the angulation go without correction will prevent me from ever getting back to boxing which entails repeated impacts on the deformed bone even after it is healed up.

Thank you for your time, I know it is hard to answer questions like these without being able to see the original x-rays.

-Travis


P.S.  I am going to try to attach a photo of the x-ray, but it will probably be poor quality.

Answer
Travis,
The 5th MT fxs can have angulation w/o to many problems.The lateral(side xray) is best to determine this. I always tell people that they will have a deformity,usually a depressed knuckle. Most if not all that I treat w/o insurance don't get surgery..even w insurance don't..now if a guy was a professional piano player maybe...but I tell them you can have less/no deformity and a scar,or a deformity and no scar..Shouldn't effect your boxing if heals properly..and if it does ever break again you can decide at that time to surgically fix