The tooth, the whole tooth: an unusual fight bite with an unnoticed embedded tooth in the hand

Abstract

A 19-year-old man presented to the plastic surgeons with a wound between his fourth and fifth metacarpophalangeal joints, with associated hand swelling and pain. He admitted to accidentally striking his brother in the mouth the previous evening. His brother reportedly made a hasty exit, and the patient dismissed the wound to his hand until waking up the next morning with swelling, pain and ascending lymphangitis. Radiographs revealed the unusual extent of his ‘fight bite’ injury with an entire human tooth embedded in his hand. Removal of the tooth and aggressive debridement was performed in theatre. Establishing an accurate account of events in these injuries can be difficult, with the orientation of the tooth in the soft tissues being more consistent with an uppercut than the reported jab. The patient made a good recovery following elevation, intravenous antibiotics, rigorous surgical debridement and postoperative hand therapy.

The “Fight Bite” Saline Joint Loading Test: Effectiveness in Detecting Simulated Traumatic Metacarpophalangeal Arthrotomies

“…However, by using small stab incisions, we were able to create precise arthrotomies, which are likely smaller than ones created by blunt incisors such as human teeth; this may help allow for a more optimal volume of saline instillation before extravasation. 16,17 The present study included a cohort of exclusively iatrogenically arthrotomized specimens without a control group. Such design precluded assessment of specificity and false-positive rates despite providing a veritable outline of sensitivity per injected saline load.…”

Whisk finger: an electric hand whisk injury with an ischaemic fingertip

“…Metal, glass and wood foreign body injuries are among the most common [2]. The range of objects described in the literature includes air gun pellets [3], knitting hooks [1], nail gun injuries [4][5][6][7][8][9][10][11], and teeth in bite injuries [12][13][14][15], with a variety of other unusual presentations reported [16]. The index finger is the most frequently affected site, followed by middle finger and thenar eminence [17].…”