title: Hand Trauma Pitfalls: A Retrospective Study of Fight Bites.
abstract: Clench fist or fight bite injuries are associated with some of the worst types of infective complications but their mechanism is often poorly understood. In a retrospective case series, 34 patients seen between 1998 and 2004 presented to a local hand surgery unit with confirmed human bite hand injuries. Seventy-six percent presented with infective complications with a mean delay in presentation of 4 days. Eighty percent of patients were clench fist injuries (CFI) (open joints in 59% and tendon injuries in 63%). Using an aggressive treatment policy including early surgical and antibiotic intervention, most patients achieved good results functionally (full range of movement was achieved in 83% of those with CFI which completed follow-up (44%)). High rates of non-compliance and incomplete follow-up was noted. Major long-term complications including limited range of movement and osteomyelitis was low and suggests the policy of prompt and comprehensive surgical and medical intervention is the optimal treatment option. A brief but in-depth discussion of the specific anatomical pitfalls is included.
authors.affiliation: Department of Plastic Surgery, Selly Oak, University Birmingham Hospital, Birmingham, UK. pat28g@yahoo.co.uk.|Department of Plastic Surgery, Selly Oak, University Hospital Birmingham, Birmingham, B296JD, United Kingdom. pat28g@yahoo.co.uk.
authors.forename: Patrick Ky
authors.initials: PK
authors.lastname: Goon
authors.affiliation: Department of Plastic Surgery, Selly Oak, University Birmingham Hospital, Birmingham, UK.
authors.forename: Matti
authors.initials: M
authors.lastname: Mahmoud
authors.affiliation: Department of Trauma and Orthopaedics, Selly Oak, University Birmingham Hospital, Birmingham, UK.
authors.forename: Vaikunthan
authors.initials: V
authors.lastname: Rajaratnam
keywords: Chondral divot fractures; Clench fist injury; Fight bites; Human bites; Punch bites