Boxer's fracture refers to the fracture of neck of 5th metacarpal bone (little finger) and often follows a blow with the fist. There may be local swelling, with flattening of knuckle. X-rays show an impacted transverse fracture with volar angulation of the distal fragment.
A flexion deformity of up to 40 degrees can be accepted; as long as there is no rotational deformity (may have cosmetic deformity but good function). The hand is immobilized in a gutter splint with the MCP joint flexed and IP joint straight until discomfort settles - a week or two - and then the hand is mobilized. The little and ring fingers are buddy-taped to prevent malrotation.
If the fracture needs reduction, this can be done under a local block. The reduced finger is immobilized using the same technique as above.