title: Teeth syndrome: diagnosis, complications and management.
abstract: Teeth syndrome or fight bite is a specific entity in hand surgery that is little known. It includes infectious complications of the hand following a fist against the teeth. Neglected or misdiagnosed this injury frequently leads to serious complications that could compromise the function of the hand. A retrospective study was performed on 20 patients treated for teeth syndrome at our department, during a period of 12 years (January 2003 to April 2015). All young adults with a mean age of 28 years and a significant male predominance. The dominant side was involved in 15 patients. Lesions were divided into 4 cases of simple dorsal wounds facing the MP joint, 8 cases of dorsal hand cellulitis, and 8 cases of arthritis and osteoarthritis of the metacarpophalangeal (MP) joint of the long fingers. The index was the most affected finger. Treatment consisted in debridement of necrotic tissues, stabilization with external fixation for arthritis, skin reconstruction was performed secondarily. Result was assessed as good in 60% of cases. Clenched fist injuries to the mouth (teeth syndrome or fight bite) are known as being the worst human bites. Usually treated as minor injuries, without realizing a breach of the joint capsule, a lesion of the extensor tendon, or a contamination by oral flora. Any patient with a wound near the joint of the hand and was involved in a fight, need an appropriate evaluation and a specialized treatment to avoid serious complications.
authors.affiliation: Orthopedic Surgery and Trauma Department, Maamouri Hospital, Nabeul, Tunisia.
authors.forename: Mohamed Ali
authors.initials: MA
authors.lastname: Sbai
authors.affiliation: Orthopedic Surgery and Trauma Department, Maamouri Hospital, Nabeul, Tunisia.
authors.forename: Sofien
authors.initials: S
authors.lastname: Benzarti
authors.affiliation: Emergency Department, Mongi Slim Hospital, Tunis, Tunisia.
authors.forename: Monia
authors.initials: M
authors.lastname: Boussen
authors.affiliation: Plastic surgery Department, La Rabta Hospital, Tunis, Tunisia.
authors.forename: Riadh
authors.initials: R
authors.lastname: Maalla
mesh_terms: D000293:Adolescent; D000328:Adult; D001168:Arthritis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001734:Bites, Human / Q000150:complications*; D002481:Cellulitis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003646:Debridement; D005260:Female; D005383:Finger Injuries / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006230:Hand Injuries / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D009336:Necrosis; D010003:Osteoarthritis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D055815:Young Adult
keywords: Hand surgery; Human bite; arthritis; cellulitis; finger
references.citation: Clin Infect Dis. 1992 Mar;14(3):633-8
references.pmid: 1562653
references.citation: Can Fam Physician. 2013 Jun;59(6):614-8
references.pmid: 23766041
references.citation: Ann Emerg Med. 1988 Dec;17(12):1321-30
references.pmid: 3057949
references.citation: Niger J Med. 2012 Apr-Jun;21(2):249-51
references.pmid: 23311202
references.citation: J Hand Surg Am. 1993 May;18(3):520-2
references.pmid: 8515028
references.citation: J Hand Surg Am. 1983 Sep;8(5 Pt 1):563-7
references.pmid: 6355264
references.citation: J Trauma. 1983 Jun;23(6):478-82
references.pmid: 6345799
references.citation: J Hand Surg Br. 1991 Nov;16(4):431-5
references.pmid: 1779160
references.citation: Open Orthop J. 2014 Jun 27;8:204-8
references.pmid: 25097675
references.citation: J Hand Surg Am. 1977 Mar;2(2):97-104
references.pmid: 845426
references.citation: N Z Med J. 1988 Jun 8;101(847 Pt 1):368-9
references.pmid: 3412695
references.citation: J Am Acad Orthop Surg. 2015 Jan;23(1):47-57
references.pmid: 25538130
references.citation: Ortop Traumatol Rehabil. 2011 Jul-Aug;13(4):399-402
references.pmid: 21857070