Infectious complications associated with toothpick injuries of the hand.
OBJECTIVE
Although rare, hand injury caused by toothpicks can result in serious complications similar to hand injury produced by human biting. To emphasize its clinical significance this article describes a group of patients sustaining hand injury induced by toothpicks.


METHODS
Eight patients who developed cellulitis, abscess, septic arthritis, and/or pyogenic tenosynovitis of flexor tendons after toothpick injuries of the hand were treated at our hospital. Seven of them required admission for antibiotics and surgical treatment.


RESULTS
The 7 admitted patients required multiple debridements (3 times on average) to control infection and administer intravenous antibiotics for mixed aerobic and anaerobic infections showing in wound cultures. The average hospital stay for the 7 patients was 26 days. At follow-up evaluation, 4 patients had full recovery of hand function after various cutaneous flap resurfacing of the wounds or staged tendon reconstruction, whereas the remaining 4 patients had arthritis with flexion contracture of interphalangeal joints or persistent paresthesia of the finger.


CONCLUSIONS
Patients injured by contaminated toothpicks should be treated with antibiotics that inhibit the growth of both aerobic and anaerobic organisms immediately after these organisms have been identified from cultures. Moreover early surgical treatment might avoid complications and obtain satisfactory results.
Chang
Ming-Chau
MC
Department of Orthopedics and Traumatology, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Huang
Yuan-Lung
YL
Liu
Yih
Y
Lo
Wai-Hee
WH
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D006230:Hand Injuries / Q000150:complications* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents