Clenched Fist Injury

Overview :

Clenched fist injuries are most common over the metacarpo phalangeal joint. Their appearance is deceptive because they do not bleed heavily and the underlying injury is hidden by soft tissue when the patient opens his hand and straightens the injured finger. CFIs can, however, have serious consequences, including infection, cellulitis, inflammation of the bone or bone marrow (osteomyelitis), septic arthritis, and inflammation of the sheaths covering the tendons of the hand (tenosynovitis). These may lead to permanent loss of function or amputation.

Most CFIs result in tissue injury due to the force of impact, ragged-edged tears in the skin resulting from contact with the teeth, and contamination of the wound by the bacteria in human saliva. As the patient opens his hand, the skin of the finger is pulled backward over the deeper part of the wound, thus sealing bacteria within the injured tissue. This sealing of the wound by normal motions of the finger is the reason why clenched fist injuries have the highest rate of infection of any human bite. The rate of infection of clenched-fist injuries varies from 15-50%.