Joe A Shaw PA-C - 2/8/2008

Question

      Dear sir,
             
                My name is john, i am a boxer and i recently broke my bone just above right hand little finger knuckle(the boxer's fracture) while punching. I did not go for a surgery or anything as per the advice of the local doc. He just fixed the bone manually and plastered it. After 2 months, when the plaster was off, the bone was still bent and upon consulting the doc convinced me it will be strainght back again in another six months. Now even after one yr. the very bone is still bent and aim really anxious about it. So I request you to let me know if it was a good idea at all that i did nt undergo any surgery for it i,e, wheter letting it heal by itself or surgery is better? Also, if the fracture would affect my total arm/punching power?   Thanx for sure

Answer
John,
He probably did right by you, but impossible to tell for sure over net of course. I would get 2nd opinion from an ortho.
What you described is not really a boxers fracture..you say you broke the bone ABOVE your 5th knuckle..this would be the base of the little finger..A BF is a fracture BELOW the 5th knuckle in the hand part.
Almost all of these will have some kind of angulation causing the bent look..the question is how much angulation is acceptable? Fractures with over 40 degrees angulation should be reduced(so I think you say he fixed the bone manually) so it sounds like he did reduce it. Pts should be told that the 5th knuckle will never be as
prominent and this may also make it appear more bent looking to you?

This same fracture in a child will usually correct itself with further growth..but you don't sound like a child to me!.

Open reduction(ie surgery) is ONLY indicated for severely angulated fractures that can't be reduced to an acceptable degree.
I think you may be a little prone to injury or fracture again with a maximal punch...but you will just have to gradually build back your strength and see how it goes.