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Hand Case 11 History/Physical Exam

Fight Bite

Any laceration or abrasion to the 3rd and 4th MCP joints of the dominant hand should be considered a "fight bite". Some patients will admit to getting into a fight, while others will omit or deny such details, so a high index of suspicion must be maintained.

If the patient presents immediately following injury, the laceration or abrasion may look deceptively unimpressive. 12-18 hours after injury there will often be swelling, pain, and signs of infection. These wounds may be small, making exploration difficult. These should be explored as best as is possible. Examine the wound while flexing and extending the MCP joint to try to bring any tendon injuries into view. Check for joint capsule defects.