TY  - JOUR
PY  - 2015//
TI  - The management of clenched fist 'fight bite' injuries of the hand
JO  - Journal of hand surgery (European volume)
A1  - Shewring, D. J.
A1  - Trickett, R. W.
A1  - Subramanian, K. N.
A1  - Hnyda, R.
SP  - 819
EP  - 824
VL  - 40
IS  - 8
N2  - We present a prospective study outlining the management of clenched fist 'fight bite' injuries. Over a 4-year period all patients with such injuries had surgical exploration with further débridements as necessary. For metacarpophalangeal joint injuries, a midline tendon-splitting approach was used. For proximal interphalangeal joint injuries, an approach was made between the lateral band and central slip of the extensor mechanism. A total of 147 patients with 159 joint injuries were treated, with 130 metacarpophalangeal joint and 29 proximal interphalangeal joint injuries. The joint was penetrated in 96% of joints overall. The number of débridements ranged from two to eight. Twenty patients defaulted within 1 week of surgery and were not included in the analysis of the results. All patients with metacarpophalangeal joint injury had satisfactory or good outcomes. A total of 42% of patients with proximal interphalangeal joint injuries had poor results, four requiring amputation and one a fusion. The tendon-splitting approach to the metacarpophalangeal joint allows excellent access and avoids damage to the sagittal bands and consequent instability of the extensor mechanism.<p />  <p>Language: en</p>
LA  - en
SN  - 1753-1934
UR  - http://dx.doi.org/10.1177/1753193415576249
ID  - ref1
ER  -