For a boxer fracture, how should the wrist be positioned in splinting?

• A. Wrist in hyperextension
• B. Wrist in flexed position
• C. Wrist straight
• D. Wrist in slightly flexed position

Answer: (D)

Boxer fracture is a fracture of the neck of the fifth metacarpal from punching. Immobilization aims to keep the fracture end stable by positioning the hand as if in a relaxed clenched fist. Placing the wrist in slight flexion achieves this: it supports the metacarpal neck by shortening and relaxing the surrounding tendons and ligaments, helping maintain reduction and preventing displacement during healing. A wrist in hyperextension or with the wrist held straight can worsen or fail to control the deforming forces across the fracture, whereas only slight flexion provides stable immobilization without undue pressure on soft tissues.