The "fight bite" injury typically occurs during altercations where the clenched fist of one individual comes into contact with the incisor teeth of another individual.
These injuries can be serious for two reasons: 1. There is often a laceration of the extensor tendon that crosses the metacarpal joint that strikes the teeth, 2. There is often an injury to the underlying joint capsule that not only causes injury to the joint capsule, but also introduces bacteria into the joint.
I prefer to treat these injuries in stages, with the first stage being washout, irrigation, debridement of the joint followed by antibiotics. Once there has been no declaration of infection I find it safe to proceed with repair of the extensor tendon. The goal is to minimize extensor lag and permit full flexion of the digit.
These injuries can be serious for two reasons: 1. There is often a laceration of the extensor tendon that crosses the metacarpal joint that strikes the teeth, 2. There is often an injury to the underlying joint capsule that not only causes injury to the joint capsule, but also introduces bacteria into the joint.
I prefer to treat these injuries in stages, with the first stage being washout, irrigation, debridement of the joint followed by antibiotics. Once there has been no declaration of infection I find it safe to proceed with repair of the extensor tendon. The goal is to minimize extensor lag and permit full flexion of the digit.
Brian P. Dickinson, M.D.
http://www.drbriandickinson.com/
http://www.drbriandickinson.com/
