Treatment of infected clench-fist human bite wounds in the area of metacarpophalangeal joints

Pyogenic Arthritis of the Metacarpophalangeal Joint Treated with External Fixation in Adolescent

“…Considerable debate exists regarding whether early joint mobilization is effective after surgery [3][4][5][6][7] . Many authors report that early joint mobilization produces a good prognosis, similar to that for the treatment of pyogenic arthritis in other joints.…”

“…However, 6 out of the 8 patients who wore an external fixator after the first debridement achieved almost complete functional recovery, suggesting that external fixation could become an important component in the treatment of pyogenic arthritis. Chadaev et al 6 also used an external fixator to distract the joint after debridement in 73 patients who showed cartilage and bone damage due to pyogenic arthritis of the metacarpophalangeal joint. Of the 73 patients, 39 (53%) showed a favorable outcome (a decrease of 15% or less in the range of motion), 24 (33%) showed a satisfactory outcome (a decrease of 15%-30% in the range of motion), and 10 (14%) patients showed an unsatisfactory outcome (a decrease of more than 30% in the range of motion).…”

“…This can be considered similar to the situation in Legg-Calvé-Perthes disease in infants, where containment of the femoral head within the acetabulum has a major impact on its regeneration. Nevertheless, the range of motion for the metacarpophalangeal joint was restricted to 0°-60°; the use of a hinged external fixator, as in Chadaev et al 6 might have resulted in a better range of motion.…”

Management of Complications of Extensor Tendon Injuries

“…The main concern acutely for these patients is the high risk of infection, 14 with associated tendon injuries a secondary concern. If localized or systemic infection develops, the treatment involves surgical debridement, broad-spectrum antibiotics, and splinting in extension.…”

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

“…They carry a significant risk of infection, due in part to the broad bacterial flora within human saliva including over 50 species, the most common being Staphylococcus aureus , followed by Streptococcus species, Corynebacterium species and Eikenella corrodens. 1–3 Puncture wounds from human teeth can inoculate these bacteria into the soft tissues of the hand, and frequently the metacarpophalangeal (MCP) joint 4. Tetanus prophylaxis ought to be offered as well as hepatitis B immunoglobulin followed by an accelerated hepatitis B vaccine course where the inoculating individual's hepatitis B status is positive 5…”