RT Book, Section A1 Breed, Meghan A1 Fitch, Robert Warne A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181041947 T1 Clenched Fist Injury (Fight Bite) T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181041947 RD 2024/03/28 AB The clenched fist injury classically occurs when the metacarpophalangeal (MCP) joint contacts human teeth, resulting in a laceration. Many patients will not divulge the true circumstances surrounding the injury; all wounds at the MCP joint, especially of the dominant hand, must be considered a fight bite until proven otherwise. Serious complications can result, including infection, loss of function, and amputation. Most wounds are polymicrobial. Patients who present early may have little evidence of intra-articular injury on examination, whereas those who present more than 18 hours after injury are more likely to have evidence of infection, including pain, swelling, erythema, and purulent drainage.