Issue 060

March 2010

What is it? 

The metacarpals are the bones that make up most of the hand. They run from the bones of the wrist to the base of each finger. When a fighter is described as having a ‘broken hand’, it is usually one of these that has been fractured.  

A fracture to one of the metacarpals that occurs just behind the knuckle joint is known as a ‘boxer’s fracture’ because it commonly occurs when punching something hard – such as a skull, elbow, or heavy bag. This usually affects the fourth and fifth metacarpals (the ones that connect to the ring and little fingers).  

Other common ways to fracture a metacarpal include getting kicked in the hand, or landing with the hand in an awkward position underneath an opponent.  

Who has it happened to?

This is a common injury among fighters. Uriah Faber fractured his fourth and fifth metacarpals during the first round of his championship rematch with Mike Brown at WEC 41. Despite his hand being badly broken, he fought the remainder of the five-round fight before losing by decision.   

Dominant heavyweight Fedor Emelianenko fractured his hand in a 2003 bout against Gary Goodridge. It healed badly and he later required surgery to put it right. He has suffered from several hand injuries throughout his career, including during his victories over Tim Sylvia (Affliction) and Brett Rogers (Strikeforce). It is unclear whether these are related to the original fracture or simply a result of his powerful and unorthodox punching style.    



Treatment

If the fracture is stable and the bone is still in the right place, then it probably won’t need much treatment. It is likely to be immobilized in some way, either by using a cast or with a soft wrap and finger taping, to ensure that the bone doesn’t move while it has time to heal.  

Alternatively, the metacarpal fracture might be displaced, so that the broken ends of the bone are no longer in line with each other. This is more likely to be the case when a fighter has fractured their hand early in a match, and continues to fight with the injury. This kind of fracture may need surgery to realign the bone so that it can heal correctly. In some cases, pins and plates may be used to hold the bone together while it heals. These are sometimes left in place, and sometimes removed later on if they cause problems.  

How long can a fighter with this injury expect to be out for?

A simple metacarpal fracture will take six to eight weeks to heal, although it may be another few weeks before a fighter feels confident punching with the injured hand. If surgery has been required, then the recovery period may be longer.  

What problems is it likely to cause? 

If the fracture heals well in the correct position then there is a good chance the fighter will suffer no long-term problems. Badly healed fractures, however, can often cause ongoing difficulty and recurrent injuries. For this reason, it’s important to get medical advice for any suspected hand fractures.  

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