Sagittal band injury: Boxer’s Knuckle

Tear of the sagittal band of the knuckle is often referred to as a boxer’s knuckle. The sagittal band is a transversely oriented ligament that helps to centralize and stabilizes the extensor tendon during joint motion.

Clinical findings:

The patient will have pain and loss of full extension of the metacarpophalangeal joint and swelling and subluxation of the extensor tendon. Snapping and subluxation of the tendon are noticed at the top of the knuckle when moving from extension to flexion.

The long finger is about 50% affected.

The radial side sagittal band is usually more than the ulnar side with ulnar subluxation of the extensor tendon.


Conservative could be tried in acute cases.Surgery in severe acute and chronic cases.