Dog bite injuries to the hand

Nygaard, Marianne; Dahlin, Lars B.

doi:10.3109/2000656x.2011.558735

Cited by 28 publications

(36 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our inpatient length of stay and operative rate are consistent with previously published reports on upper extremity DBIs. 1,8,20,27 In a subset of upper extremity DBIs, nerve, tendon, and vascular abnormalities are noted on physical exam, and there is a paucity of published literature documenting the surgical exploration of these structures. 5,6,16,20,28 In our study, nerve palsy on physical exam was highly predictive of discovering nerve damage during surgical exploration, which ranged from minor contusions to complete lacerations.…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors of Neurovascular and Tendon Injuries Following Dog Bites to the Upper Extremity

Alluri

Pannell

Heckmann

et al. 2016

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Background: Dog bite injuries to the upper extremity can result in traumatic neurovascular and musculotendinous damage. Currently, there are no clear guidelines dictating which patients may benefit from early operative exploration. The purpose of this study was to identify clinical variables that were predictive of abnormal intraoperative findings in patients who sustained an upper extremity dog bite injury. Methods: All patients who presented to a level I trauma center between 2007 and 2015 with an upper extremity dog bite injury who underwent subsequent surgical exploration were retrospectively screened for inclusion in our study. Patients with inadequate documentation or preexisting neurovascular or motor deficits were excluded. Abnormalities on physical exam and injuries encountered during surgical exploration were recorded for each patient. Contingency tables were constructed comparing normal and abnormal nerve, tendon, and vascular physical exam findings with intact or disrupted neurovascular and musculotendinous structures identified during surgical exploration. Results: Between 2007 and 2014, 117 patients sustained a dog bite injury to the upper extremity, of which 39 underwent subsequent surgical exploration and were included in our analysis. Sixty-nine percent of patients with neuropraxia on exam had intraoperative nerve damage. Seventy-seven percent of patients with an abnormal tendon exam had intraoperative musculotendinous damage. One hundred percent of patients with an abnormal vascular physical exam had intraoperative arterial injury. Conclusions: To date, there are no clear guidelines on what clinical criteria indicate the need for operative exploration and possible repair of neurovascular structures in upper extremity dog bite injuries. In our study, nerve, tendon, and vascular abnormalities noted on physical exam were strongly predictive of discovering neurovascular and musculotendinous damage during surgical exploration.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictive Factors of Neurovascular and Tendon Injuries Following Dog Bites to the Upper Extremity

Alluri

Pannell

Heckmann

et al. 2016

Hand (New York, N,Y.)

View full text Add to dashboard Cite

show abstract

“…Bite injuries to the hand are predominantly caused by mammals: dogs, cats and humans and represent a common emergency presentation. The estimated lifetime risk of being bitten by a domestic animal is around 50% [2], and these injuries account for 1-2% of emergency attendances in the US with an associated annual medical cost of over $100 million [3]. Approximately 30-40% of all hand infections are attributable to human or animal bites [4].…”

Section: Introductionmentioning

confidence: 99%

Mammalian Bite Injuries to the Hand and Their Management

Jha¹,

Khan²,

Siddiqui³

2014

TOORTHJ

View full text Add to dashboard Cite

Bite wounds are a common form of hand injury with the potential to lead to severe local and systemic sequelae and permanent functional impairment. Mammalian bite wounds may be caused by a variety of animal class and species; injuries resulting from dogs, cats and humans are the most widely discussed and reported in the literature. Bite wounds may be contaminated with aggressive pathogens and the anatomical vulnerability of structures within the hand means that without early recognition and treatment with irrigation and antibiotics, alongside a low index of suspicion for deep structural involvement requiring formal surgical exploration and washout, the consequences of such injuries can be disastrous. We review the literature and discuss the epidemiology, pathophysiology and microbiology relating to these injuries, as well as clinical aspects including signs, symptoms, and management.

show abstract

“…2 The upper extremity is frequently affected, and hand injuries occur in 30% of cases. 3,4 The superficial location of nerves, blood vessels, tendons, and small joints in the wrist and hand renders these structures vulnerable to injury. 3,5 Moreover, bite wounds to the hand have been shown to be more susceptible to infection than those in other anatomical regions, in part owing to the presence of multiple closed spaces including tendon sheaths and fibrous septa in the fingertip and thenar and midpalmar spaces.…”

mentioning

confidence: 99%

“…3,4 The superficial location of nerves, blood vessels, tendons, and small joints in the wrist and hand renders these structures vulnerable to injury. 3,5 Moreover, bite wounds to the hand have been shown to be more susceptible to infection than those in other anatomical regions, in part owing to the presence of multiple closed spaces including tendon sheaths and fibrous septa in the fingertip and thenar and midpalmar spaces. 5 Approximately 30% to 40% of all hand bites develop clinical infection, and over half of these are caused by dog and cat bites.…”

mentioning

confidence: 99%

“…1,6 Other hand infections after animal bites include septic tenosynovitis, arthritis, and osteomyelitis. 3,5 Disseminated infections with severe sepsis are rare. 1 One pathogen that has been associated with life-threatening septicemia after dog bites is Capnocytophaga canimorsus, a fastidious gramnegative bacillus that colonizes the oral cavity of animals, particularly dogs and cats.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Capnocytophaga canimorsus Sepsis Following a Minor Dog Bite to the Finger: Case Report

Dedy

Coghill

Chandrashekar

et al. 2016

The Journal of Hand Surgery

View full text Add to dashboard Cite

Capnocytophaga canimorsus is a gram-negative bacillus present in the oral cavities of 22% to 74% of healthy dogs. Capnocytophaga canimorsus has unique virulence factors that enable it to evade the human immune system and cause life-threatening sepsis following a dog bite. We report a previously well 68-year-old woman who presented with septic shock and multiorgan failure following a seemingly minor dog bite to the finger. The patient required intensive care treatment, intravenous antibiotic therapy, and multiple surgical procedures including amputation of the affected finger. The septicemia and coagulopathy that ensued resulted in gangrene and amputation of additional fingers and toes. The purpose of this report is to raise awareness of this organism among hand surgeons when faced with a patient presenting in septic shock and minimal signs at the site of a dog bite.

show abstract

Dog bite injuries to the hand

Abstract: We suggest that education of the owners and the public, reporting of all bites and control of animals are some of the actions to reduce decrease the number of attacks. At least one serious case could have been prevented if the dog had been put down after a previous serious attack.3

Cited by 28 publications

References 13 publications

Predictive Factors of Neurovascular and Tendon Injuries Following Dog Bites to the Upper Extremity

Predictive Factors of Neurovascular and Tendon Injuries Following Dog Bites to the Upper Extremity

Mammalian Bite Injuries to the Hand and Their Management

Capnocytophaga canimorsus Sepsis Following a Minor Dog Bite to the Finger: Case Report

Contact Info

Product

Resources

About