Boxer's fracture involves fracture at the neck of which metacarpal?

• A. Neck of the 3rd metacarpal
• B. Base of the 1st metacarpal (thumb)
• C. Neck of the 5th metacarpal
• D. Head of the 5th metacarpal

Answer: (C)

Boxer's fracture is a fracture through the neck of the fifth metacarpal, typically from punching a hard object with a clenched fist. The force drives the distal fragment of the little finger metacarpal head forward and causes a transverse fracture at the neck just below the head, often with palmar angulation. This location is most common because the fifth metacarpal bears much of the load during a punch, making its neck the weakest point when the fist strikes impact. Fractures at the base of the thumb metacarpal are Bennet’s/Rolando-type injuries and involve the thumb joint, not the classic boxer's pattern. A fracture at the head of the fifth metacarpal would be distal to the metacarpal neck and presents differently, not the typical boxer's fracture.