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Written by Dr. Beau B Hightower MS, DC, CSCS, CES
While watching Carlos Condit and Johny Hendricks battle to fight of the night status, Joe Rogan made several comments about Hendricks’s busted left hand. It turns out that his hand may be fine, but a fractured hand or “boxers break” is a common injury in the fight world. Let’s talk about what this injury is and what it means to the fighter’s that sustain them.
Veteran MMA fighter Anthony “Rumble” Johnson suffered a “boxer’s break” at the end of his World Series of Fighting victory over Andrei Arlovski. A boxer’s fracture is a fracture of the 4th or 5th metacarpal bone or ring finger which is essentially the part of your hand that connects your ring finger or “pinky” finger to your wrist. Many fighters experience this type of injury and it is almost always caused by striking an opponent. These fractures can keep fighters out of the cage or ring for weeks at a time. They are diagnosed by history and then an X-Ray of the hand.
This injury is also called a “bar room fracture” or “Barroom Fracture”. “Bar room fractures” are the most common type of hand fracture and are appropriately named for gentlemen and women who have had too much to drink and swing wildly during a physical confrontation. Proper punching form will allow the first two knuckles to align with the scaphoid bone in the wrist and the radius. This allows transfer of force along the strongest bones in the forearm with minimal angular torque. When the hand makes contact with a skull or shoulder, the “pinky” knuckle is physically the weakest bone in the hand and will fracture. Conservative treatment will involve splinting or casting the hand so that the bone is allowed to heal in the absence of gross misalignment. Angulation is the misalignment of the metacarpal bones. If the injury causes angulation of the metacarpal bones this can lead to surgery the cut off for surgery is typically 70 degrees of angulation. Surgery is recommended if the bones are badly misaligned and the doctor is unable to correct the bones by pulling or pushing.
This type of injury is common and must be evaluated to ensure no fracture is found. Other injuries to the hand can include sprains, dislocations, and benign tumors. A fracture such as a “boxer’s break” can potentially keep a fighter in a cast for up to 6 weeks and perhaps longer if surgery is required. The medical literature also suggests that once a bone has been fractured, it is more likely to be fractured again. Properly applied hand wraps help to stabilize the hand and can help fighters to avoid this type of injury. Also, it is imperative that the fighter strike with proper form to ensure that contact is made in a bio-mechanically correct position.
“Rumble” Johnson scored a significant win as he attempts to continue his career resurrection. He will have to wait to let his hand heal before he gets back in the ring, but in any case, we have to give him congrats (and a hand) for a hard fought victory, even with the dreaded “boxer’s break”.
Dr. Beau Hightower is a former collegiate athlete and avid fight fan. He serves as the President of Elite Ortho-Therapy and Sports Medicine LLC, the premier sports injury resolution center in New Mexico.