From the Guidelines
Boxing hand dislocations require immediate medical attention, and initial imaging with radiographs of the area of interest is usually appropriate. When suspecting a hand dislocation from boxing, it is crucial not to attempt to reset the joint yourself, as this can lead to further injury. Instead, immobilize the hand, apply ice for 15-20 minutes every 1-2 hours, and take over-the-counter pain medication like ibuprofen (400-600mg every 6 hours) or acetaminophen (500-1000mg every 6 hours) to manage pain and inflammation. According to the American College of Radiology Appropriateness Criteria 1, radiographs are the initial imaging modality of choice for adults with acute blunt or penetrating trauma to the hand or wrist.
Key considerations in managing boxing hand dislocations include:
- Immobilization of the affected hand to prevent further injury
- Application of ice to reduce swelling and pain
- Use of over-the-counter pain medications for symptom management
- Seeking immediate medical attention for proper evaluation and treatment
- Potential need for advanced imaging (such as MRI or CT) if initial radiographs are negative or equivocal, as suggested by Variant 2 of the ACR Appropriateness Criteria 1
- Importance of proper reduction, usually under local anesthesia or sedation, followed by splinting or casting for an appropriate duration, typically 3-6 weeks
- The role of physical therapy in the rehabilitation process to restore strength and range of motion
Complications of untreated hand dislocations can be severe, including chronic pain, decreased grip strength, joint instability, and early-onset arthritis. Prevention strategies are also critical and include proper hand-wrapping technique, using quality gloves, maintaining good punching form, and strengthening hand and wrist muscles. By prioritizing immediate medical attention and following evidence-based guidelines for imaging and treatment, individuals with boxing hand dislocations can minimize the risk of long-term complications and optimize their recovery and return to activity.
From the Research
Boxing Hand Dislocation
- Boxing hand injuries are common, with the hands being one of the most frequently injured areas in boxing 2
- Injuries to the hands and wrist are common in athletes, including acute fractures, dislocations, ligamentous, and tendon injuries 3
- There is no specific evidence in the provided studies regarding boxing hand dislocation, but it can be inferred that hand and wrist injuries, including dislocations, are a significant concern in boxing 4, 2, 3
- The treatment of hand injuries in boxing, such as boxer's knuckle and traumatic carpal boss, involves precise operative treatment, including direct repair of the disrupted extensor hood and arthrodesis of the destabilized carpometacarpal joints 4
- Medical care for boxers extends beyond the competition in the boxing ring, and ringside physicians must be prepared to care for boxers with various injuries, including hand and wrist injuries 2