Boxer's fracture: an indicator of intentional and recurrent injury

The objective was to describe the population of patients presenting with a boxer's fracture (BF), to determine how often BF is an intentional injury, to determine if it is a predictor of recurrent injury, and to compare the rates of intentional injury and injury recidivism between patients with BF and those with other injuries. An emergency department (ED)-based injury surveillance system (EDBISS) in a university-affiliated ED (census of 35,000) provided data on injured patients presenting between January 1, 1995 and December 31, 1996. Chart review was performed. Descriptive analyses were performed. The results showed 22,728 of 69,438 (33%) ED visits during a 2-year period were attributable to injuries. Sixty-two patients presented with BF. Mean age of BF patients was 22.1 versus 28.6 for all injured (P < .005). Ninety-two percent (57/62) of BF patients were men compared with 58% of all injured (P < .0001). Thirty-eight of 62 (61%) BF injuries were sustained after intentional punches of an object/person. Seventeen of 62 (27%) BF patients were injury recidivists. Previous studies in this same ED population showed that 6% had intentional injuries and 12% were injury recidivists. BF is usually an intentional injury and these patients are at increased risk for recurrent injury. Clinicians should focus prevention efforts on this high-risk population.