very rare cases to provide a more detailed picture. Prevention Boxers and other combat athletes routinely use hand wraps and boxing gloves to help stabilize the hand, greatly reducing pain and risk of injury during impact. Proper punching form is the most important factor to prevent this type of fracture. Treatment Ice is applied to relieve pain and swelling. Any open wounds are cleansed to avoid infection. For most fractures with less than 70 degrees of angulation, buddy taping and a tensor bandage resulted in similar outcomes to reduction with splinting. Conservative treatment with early mobilization has also been found non-inferior when compared to surgical treatment with bouquet pinning for fractures presenting with less than 45 degrees of palmar angulation. In rare cases when the fracture causes rotational deformity or severe angulation surgery may be required to place pins or plates in the bone to hold the pieces in place. Prognosis Prognosis for these fractures is generally good, with total healing time not exceeding 12 weeks. The first two weeks will show significantly reduced overall swelling, with improvement in clenching ability showing up first. Ability to extend the fingers in all directions appears to improve more slowly. Hard casts are rarely required, and soft casts or splints can be removed for brief periods of time to allow for cleaning and drying the skin underneath the splint. Pain from injury varies person to person as with most injuries cannot, in all honesty, be generalized. Depending on the individual a course of over the counter or narcotic pain medication will suffice. Muscle atrophy of 5 to 15 percent may be expected, with a rehabilitation period of approximately 4 months given adequate therapy. In the mildest of cases, full rehabilitation status can be achieved within 3 to 4 months. Epidemiology Hand and wrist injuries are reported to account for fifteen to twenty percent of emergency room injuries, and metacarpal fractures represent a significant number of those injuries. Hand injuries of this sort are most prevalent among fifteen- to thirty-five-year-old males, and the fifth metacarpal is the one most commonly affected. Males are nearly fifty percent more likely to sustain fracture from a punch mechanism than females. Male intentional punch injuries are correlated predominantly with social deprivation, while female punch intentional injuries show more correlation with psychiatric disorders. Approximately 3.7 male hand injuries, per 1000, per year, and 1.3 female hand injuries, per 1000,