PT  - JOURNAL ARTICLE
AU  - Vijayan, Roshan
AU  - Awad, Guirgis
TI  - The tooth, the whole tooth: an unusual fight bite with an unnoticed embedded tooth in the hand
AID  - 10.1136/bcr-2015-209313
DP  - 2015 May 02
TA  - BMJ Case Reports
PG  - bcr2015209313
VI  - 2015
4099  - http://casereports.bmj.com/content/2015/bcr-2015-209313.short
4100  - http://casereports.bmj.com/content/2015/bcr-2015-209313.full
AB  - A 19-year-old man presented to the plastic surgeons with a wound between his fourth and fifth metacarpophalangeal joints, with associated hand swelling and pain. He admitted to accidentally striking his brother in the mouth the previous evening. His brother reportedly made a hasty exit, and the patient dismissed the wound to his hand until waking up the next morning with swelling, pain and ascending lymphangitis. Radiographs revealed the unusual extent of his ‘fight bite’ injury with an entire human tooth embedded in his hand. Removal of the tooth and aggressive debridement was performed in theatre. Establishing an accurate account of events in these injuries can be difficult, with the orientation of the tooth in the soft tissues being more consistent with an uppercut than the reported jab. The patient made a good recovery following elevation, intravenous antibiotics, rigorous surgical debridement and postoperative hand therapy.