Predicting serious complications and high cost of treatment of tooth-knuckle injuries: a systematic literature review

Smith, H. R.; Hartman, Holly; Loveridge, J.; Gunnarsson, Ronny

doi:10.1007/s00068-016-0701-6

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…Mammalian bite wounds have a high risk of infection—2% to 25% of dog bites,9 30% to 50% of cat bites,9 and up to half (47%) of human bites41—which increases with delay to presentation and size of wound 1042. While only 8% of human bites are closed fist (“fight bite”) injuries,21 one systematic review43 reported frequent infectious complications, including tenosynovitis (36%), septic arthritis (70%), and osteomyelitis (48%).…”

Section: When Should Antibiotic Prophylaxis Be Offered?mentioning

confidence: 99%

Management of mammalian bites

Colmers

Tulloch

Dostaler

et al. 2023

BMJ

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Section: When Should Antibiotic Prophylaxis Be Offered?mentioning

confidence: 99%

Management of mammalian bites

Colmers

Tulloch

Dostaler

et al. 2023

BMJ

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“…Clenched fist injury is a 3-5 mm laceration over the metacarpophalangeal joint or proximal interphalangeal joint, being often sustained from incisor teeth touching to the bone or into the joint. After the extension of the fingers the tendon slides backwards covering the lacerated joint capsule where the contaminants from the teeth grow and induce an infection, which, if neglected, might aggravate and expand towards the dorsal sub-aponeurotic space of the dorsal hand and cause septic arthritis of the adjacent joint [55,56]. Hospitalization and consultation of a hand surgeon are necessary for all bite wounds of the hand that involve the bones and/or joints.…”

Section: Infections At the Deep Anatomical Compartmentsmentioning

confidence: 99%

Infections of Deep Hand and Wrist Compartments

et al. 2020

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The human hand is the most exposed part of the body to highest risk for injuries, loss of the skin integrity, and to the inoculation of bacteria, most commonly Staphylococcus aureus, Streptococcus β-haemolytic, and gram-negative. In case of an infection, the mobile anatomical structures and the synovial membranes in close proximity to each other may spread the pus towards deep spaces and compartments. Mild early infections without an abscess formation may respond to antibiotics, but at more advanced stage, erythema, swelling, stiffness, and severe pain may ensue. Abscess formation will cause debilitating pain, fever, systemic symptoms, and even sepsis. Necrotizing infections may threaten not only the limb, but also patient’s life. Therefore, an initially “trivial” hand injury should never be neglected, as it might turn into a deep space infection, which must be treated immediately with drainage, wound debridement, and i.v. antibiotics. Delay in diagnosis and inadequate initial management might rapidly lead to abscess formation, destruction of the gliding surfaces and the normal anatomy, and irreparable functional deterioration.

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“…Tenosynovitis, septic arthritis, osteomyelitis, and residual stiffness are common serious complications. 61 Patients who present more than 8 days after sustaining bite injury have a 18% chance of undergoing amputation. 62 A radiograph (Brewerton view) can reveal fracture of the metacarpal head, retained foreign body (tooth fragment), or osteomyelitis.…”

Section: Human Bitesmentioning

confidence: 99%