In a boxer fracture, which finding indicates referral for reduction in addition to angulation?

In a boxer fracture, which finding indicates referral for reduction in addition to angulation?

• A. Extensor lag
• B. Swelling only
• C. Pain only
• D. Discoloration

Answer: (A)

Extensor lag signals a mechanical problem with the finger’s extensor mechanism from the fracture, which is a key reason to refer for reduction in boxer's fractures. A fifth metacarpal neck fracture often angulates palmarly, and some cases tolerate immobilization. But when the finger cannot actively straighten fully—an extensor lag—the deformity disrupts tendon tension and joint alignment, making healing with simple splinting unreliable. Reducing the fracture realigns the distal fragment, restores extensor mechanism function, and improves the chance of full recovery of movement and grip. Swelling, pain, or discoloration can accompany many injuries but do not by themselves indicate the need for reduction unless they accompany or reveal extensor dysfunction or instability.

Extensor lag signals a mechanical problem with the finger’s extensor mechanism from the fracture, which is a key reason to refer for reduction in boxer's fractures. A fifth metacarpal neck fracture often angulates palmarly, and some cases tolerate immobilization. But when the finger cannot actively straighten fully—an extensor lag—the deformity disrupts tendon tension and joint alignment, making healing with simple splinting unreliable. Reducing the fracture realigns the distal fragment, restores extensor mechanism function, and improves the chance of full recovery of movement and grip. Swelling, pain, or discoloration can accompany many injuries but do not by themselves indicate the need for reduction unless they accompany or reveal extensor dysfunction or instability.