Fifth metacarpal transverse neck fracture from a straight punch is called which?

• A. Colles fracture
• B. Boxer's fracture
• C. Smith fracture
• D. Bennett fracture

Answer: (B)

Boxer's fracture is a fracture through the neck of the fifth metacarpal caused by a direct blow with a clenched fist, such as a straight punch. It earned its name because it’s the classic hand injury seen in boxers who punch objects. The mechanism places stress along the metacarpal neck, leading to a simple fracture with possible palmar (volar) angulation of the distal fragment. Clinically, patients often have pain, swelling, and tenderness around the little-finger knuckle, and x-rays show a fracture line at the neck of the fifth metacarpal. Management usually involves immobilization in an ulnar gutter splint, with more than minimal angulation or rotation potentially requiring reduction or surgical fixation. Other well-known wrist/hand fractures involve different bones or joints (for example, those at the distal radius or the base of the thumb metacarpal), so they are not the same pattern as this injury.