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Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage?

Almost 2% of all emergency admissions involve an animal bite. While horses bite humans very rarely, their bites are mostly associated with fatalities. Herein, we report the case of a 23-year old bitten by a domestic horse causing a crush injury to his fourth finger with fracture dislocation of the p...

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Autores principales: Elghoul, Naoufal, Jalal, Youssef, Bouya, Ayoub, Zine, Ali, Jaafar, Abdeloihab
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374822/
https://www.ncbi.nlm.nih.gov/pubmed/30838145
http://dx.doi.org/10.1155/2019/2156269
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author Elghoul, Naoufal
Jalal, Youssef
Bouya, Ayoub
Zine, Ali
Jaafar, Abdeloihab
author_facet Elghoul, Naoufal
Jalal, Youssef
Bouya, Ayoub
Zine, Ali
Jaafar, Abdeloihab
author_sort Elghoul, Naoufal
collection PubMed
description Almost 2% of all emergency admissions involve an animal bite. While horses bite humans very rarely, their bites are mostly associated with fatalities. Herein, we report the case of a 23-year old bitten by a domestic horse causing a crush injury to his fourth finger with fracture dislocation of the proximal interphalangeal joint. The patient benefited upon arrival at the emergency department from copious irrigation with saline serum, tetanus toxoid, postexposure rabies vaccination, and prophylactic antibiotic therapy. In the operating room, surgical exploration found the ulnar digital pedicle sectioned, the flexor and extensor tendons sectioned and shredded, and the skin shredded. An excisional debridement of devitalized tissue with copious irrigation was performed, and the finger regularized at the level of traumatic amputation with tendon striping followed by coverage of the bone by the radial digital flap with careful clinical and biological monitoring after the surgery. At the last follow-up, the patient revealed no sign of infection, and he returned to his usual activities and has been discharged from care. This wound management, based on a careful examination, a meticulous debridement, and an efficient cleaning with early and targeted antibiotic therapy, might promote good results and avoid dangerous complications.
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spelling pubmed-63748222019-03-05 Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage? Elghoul, Naoufal Jalal, Youssef Bouya, Ayoub Zine, Ali Jaafar, Abdeloihab Case Rep Infect Dis Case Report Almost 2% of all emergency admissions involve an animal bite. While horses bite humans very rarely, their bites are mostly associated with fatalities. Herein, we report the case of a 23-year old bitten by a domestic horse causing a crush injury to his fourth finger with fracture dislocation of the proximal interphalangeal joint. The patient benefited upon arrival at the emergency department from copious irrigation with saline serum, tetanus toxoid, postexposure rabies vaccination, and prophylactic antibiotic therapy. In the operating room, surgical exploration found the ulnar digital pedicle sectioned, the flexor and extensor tendons sectioned and shredded, and the skin shredded. An excisional debridement of devitalized tissue with copious irrigation was performed, and the finger regularized at the level of traumatic amputation with tendon striping followed by coverage of the bone by the radial digital flap with careful clinical and biological monitoring after the surgery. At the last follow-up, the patient revealed no sign of infection, and he returned to his usual activities and has been discharged from care. This wound management, based on a careful examination, a meticulous debridement, and an efficient cleaning with early and targeted antibiotic therapy, might promote good results and avoid dangerous complications. Hindawi 2019-01-30 /pmc/articles/PMC6374822/ /pubmed/30838145 http://dx.doi.org/10.1155/2019/2156269 Text en Copyright © 2019 Naoufal Elghoul et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Elghoul, Naoufal
Jalal, Youssef
Bouya, Ayoub
Zine, Ali
Jaafar, Abdeloihab
Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage?
title Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage?
title_full Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage?
title_fullStr Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage?
title_full_unstemmed Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage?
title_short Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage?
title_sort domestic horse bite: an unusual etiology of crush injury of the fourth finger—how to manage?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374822/
https://www.ncbi.nlm.nih.gov/pubmed/30838145
http://dx.doi.org/10.1155/2019/2156269
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