The management of clenched fist 'fight bite' injuries of the hand

The Journal of Hand Surgery, European Volume
D J ShewringR Hnyda

Abstract

We present a prospective study outlining the management of clenched fist 'fight bite' injuries. Over a 4-year period all patients with such injuries had surgical exploration with further débridements as necessary. For metacarpophalangeal joint injuries, a midline tendon-splitting approach was used. For proximal interphalangeal joint injuries, an approach was made between the lateral band and central slip of the extensor mechanism. A total of 147 patients with 159 joint injuries were treated, with 130 metacarpophalangeal joint and 29 proximal interphalangeal joint injuries. The joint was penetrated in 96% of joints overall. The number of débridements ranged from two to eight. Twenty patients defaulted within 1 week of surgery and were not included in the analysis of the results. All patients with metacarpophalangeal joint injury had satisfactory or good outcomes. A total of 42% of patients with proximal interphalangeal joint injuries had poor results, four requiring amputation and one a fusion. The tendon-splitting approach to the metacarpophalangeal joint allows excellent access and avoids damage to the sagittal bands and consequent instability of the extensor mechanism.

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Citations

Oct 28, 2016·Der Unfallchirurg·F UnglaubC K Spies
Jul 2, 2016·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·H R SmithR Gunnarsson
Mar 29, 2018·The Journal of Hand Surgery, European Volume·David J ShewringAdam Smith
Sep 14, 2018·Operative Orthopädie und Traumatologie·D Saul, K Dresing
Nov 10, 2018·Substance Use & Misuse·Thomas LyonsThomas Kenemore
Feb 28, 2019·Hand : Official Journal of the American Association for Hand Surgery·Carl M HarperTamara D Rozental
Jul 4, 2019·AJR. American Journal of Roentgenology·Catherine N Petchprapa, Devin Vaswani
Dec 11, 2019·The Journal of Hand Surgery, European Volume·Julia Blackburn, Daniel Armstrong
Jun 7, 2020·Microorganisms·Konstantinos N MalizosZoe C Dailiana
Sep 30, 2020·The Journal of Hand Surgery, European Volume·Harrison F KayLuke T Nicholson
Mar 5, 2020·Case Reports in Plastic Surgery & Hand Surgery·Sacha LardenoyeJan A Ten Bosch
Dec 21, 2019·Der Unfallchirurg·M LandegT Neuhof
Mar 17, 2021·Der Unfallchirurg·Martin LangerSimon Oeckenpöhler
Jun 17, 2021·Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deut·Frank EichenauerStefan Weber

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Methods Mentioned

BETA
lavage
amputation

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