Human bite injuries of the hand.

The charts of 24 patients admitted to Victoria Hospital, London, Ontario with human bite injuries were analysed. Two clinical groups were found. One group of patients had evidence of septic arthritis. They required operative treatment and experienced complications. The second group was made up of patients with cellulitis who responded to antibiotic therapy and had an uncomplicated course. No resistance to cephalosporins was found. Patients seen soon after injury without evidence of joint penetration should be managed by irrigation and open management of the wound, immobilization in a hand dressing, elevation, tetanus prophylaxis, oral administration of a cephalosporin and reexamination within 24 hours. Those who fail to respond to this treatment should be admitted to hospital and given antibiotics intravenously. Clinical evidence of septic arthritis warrants early operative incision and drainage combined with antibiotics given intravenously.