Star InactiveStar InactiveStar InactiveStar InactiveStar Inactive

Poorly Thrown Punches

Author: Mark Ringer, MD
Peer-reviewer: Matthew Negaard, MD, CAQ-SM
Final editor: Alex Tomesch, MD, CAQ-SM

A 23 year-old male presents to the emergency department endorsing acute right hand pain that started after getting into a bar fight. There is point tenderness over the lateral aspect of the right hand and pain with movement of the 4th and 5th digits. Sensation noted to be intact. 

Image 1. Case courtesy of Dr. Mark Hopkins, from the Ortho EM Pearls image bank


[1] Hussain, M. H., Ghaffar, A., Choudry, Q., Iqbal, Z., & Khan, M. N. (2020). Management of Fifth Metacarpal Neck Fracture (Boxer's Fracture): A Literature Review. Cureus, 12(7), e9442.

[2] Datir, A., Knipe, H. Boxer fracture. Reference article, (accessed on 03 Feb 2022) 

[3] Sehmbi H, Madjdpour C, Shah UJ, Chin KJ. Ultrasound guided distal peripheral nerve block of the upper limb: A technical review. J Anaesthesiol Clin Pharmacol. 2015 Jul-Sep;31(3):296-307. doi: 10.4103/0970-9185.161654. PMID: 26330706; PMCID: PMC4541174.