A Mislead Human Bite Cause a Septic Arthritis with Articular Destruction of the Fifth Metacarpophalangeal Joint: A Case Report and Review of the Literature

Abstract

Due to severe and fatal complications that can cause the human bite injuries to the joint; these injuries were described as “the cancer of the hand”. Human bites are less common than domestic animal bites, accounting for only 2% of hand bites. Moreover, if a human bite wound occurred in the hand, it may lead to severe infection as septic arthritis and osteomyelitis which its incidence account about only 2%. Herein, we report a rare case of a 22 years old man who presented a “minor” wound of the hand due to clenched fist human bite, managed initially inadequately leading to massive destruction of the fifth metacarpophalangeal joint, prompting the patient to undergo surgery. In the operating theater, we realized a debridement of devitalized tissue, collection of bacteriological samples and we curetted the joint surfaces along with copious irrigation with saline serum (2 liters). One gram of Amoxicillin-clavulanic acid were administrated after realizing bacteriological samples then one gram every eight hours. The wound was left open and closed secondary. Then, a dressing with betadine was applied followed by careful clinical and biological daily monitoring along with an early postoperative range of motion. At the last follow up, the patient showed no sign of infection with no pain but he kept a residual stiffness of his fifth finger. Through this observation, we emphasize that physicians should be alert about the danger if this injury is underestimated.