A Boxer’s fracture is a break in one of the metacarpal bones of the hand, typically occurring near the knuckle of the little finger (the fifth metacarpal neck). This injury is commonly caused by striking a hard object with a closed fist. This guide provides instructions for temporary stabilization of a suspected Boxer’s fracture using the buddy taping technique. This wrapping minimizes movement and offers support until a medical professional can provide a full diagnosis and definitive care.
Identifying the Boxer’s Fracture and Stabilization Goals
A suspected metacarpal fracture displays several signs immediately following the injury. Noticeable swelling and bruising will appear over the back of the hand near the affected knuckle. The knuckle may appear “depressed” or less prominent compared to the uninjured hand, with pain centered at this point. A rotational deformity might also be visible, where the injured finger overlaps the adjacent finger when attempting to make a fist.
The primary goal of temporary stabilization is to reduce pain and prevent further displacement of the broken bone fragments. Minimizing movement at the fracture site avoids additional soft tissue damage during transport. A confirmed diagnosis of a Boxer’s fracture requires an X-ray performed by a healthcare provider to assess the degree of bone angulation and displacement.
Supplies and Preparation for Wrapping
Effective temporary stabilization requires specific materials for support and skin integrity. You will need a roll of medical-grade tape (cloth or zinc oxide), preferably 1/2 to 1 inch wide, and scissors. Soft padding, typically non-adhesive cotton or gauze, is also needed. This padding will be placed between the fingers to prevent skin irritation and maceration from moisture.
Before applying any tape, the skin should be clean and dry; an antiseptic or alcohol wipe is recommended to remove dirt and oils. The padding must be placed between the injured little finger (fifth digit) and the adjacent ring finger (fourth digit), extending the entire length of the fingers. This padding acts as a cushion and prevents the skin from rubbing together. The hand should be positioned in a functional, relaxed curve, with the fingers slightly bent, to prepare for the stabilization wrap.
Step-by-Step Buddy Taping Method
The temporary stabilization method involves securing the injured little finger to the adjacent healthy ring finger. This technique, known as buddy taping, uses the strong, uninjured finger as a splint to restrict motion of the fractured digit. Buddy taping provides similar functional outcomes to traditional casting for certain uncomplicated fractures.
The first anchor point for the tape should be placed just below the proximal interphalangeal (PIP) joint (the middle joint of the finger). Wrap the tape firmly around both the little and ring fingers. Ensure the tape does not cross over the joint itself, as this restricts the slight movement necessary for blood circulation and preventing stiffness. A second piece of tape should be applied below the distal interphalangeal (DIP) joint, near the fingertip, following the same principle of avoiding the joint crease.
If the fingers are long, a third piece of tape may be applied in the center of the middle phalanx for added support, avoiding the joint lines. After applying the tape, gently press on the nail beds of both fingers until they turn pale, then release the pressure. The color should return immediately, typically within two seconds; if the return is delayed, the tape is too tight and must be reapplied.
The tape should be snug enough to hold the fingers firmly together, but never so tight that it causes numbness, tingling, or discoloration. Buddy taping is a temporary measure designed to reduce pain and prevent rotational movement until professional treatment is sought. The tape should be changed and the skin checked every one to two days to monitor for irritation.
When to Seek Emergency Medical Attention
While temporary stabilization is important, all suspected fractures require professional medical evaluation and imaging. A healthcare provider must assess the severity of the fracture with an X-ray to determine the degree of angulation and displacement before providing definitive treatment.
Immediate emergency medical attention is necessary if any signs of neurovascular compromise are present. These signs include persistent numbness, severe tingling, or pale or blueish discoloration of the fingers, which indicates poor blood flow. Uncontrolled pain that does not respond to common pain relievers is also an urgent sign requiring professional attention.
Any open wound over the injury site must be treated as a potential open or compound fracture. These injuries carry a high risk of infection and require immediate surgical debridement and intravenous antibiotics. Under no circumstances should you attempt to manually straighten or “set” the finger, as this can cause further damage to the surrounding nerves and blood vessels.