Fight Bites

• Any abrasion or laceration over the knuckles should be presumed to be a fight bite.  Patients will often lie about the circumstances of the laceration.
• Radiographs should be obtained on all of these patients to exclude
  • Retained foreign bodies (e.g., tooth fragments)
  • Fracture of the metacarpal head
• Place patient on amoxicillin/clavulanic acid or clindamycin to cover mouth flora
• Irrigate wound well, and explore through the fingers full range of motion to exclude joint or tendon injury.
• Refrain from suturing the wound, as this will increase the risk of infection.
• Splint in position of function and have them follow up in 2 days.