Lewellyn Brett, Young Matthew, Blanco Paula
Department of Orthopaedics, Orlando Health Level One Orthopaedics, Orlando, Florida, United States.
J Orthop Case Rep. 2024 Dec;14(12):83-88. doi: 10.13107/jocr.2024.v14.i12.5028.
Cat bites are a remarkably common injury seen in the emergency department setting . Due to the morphology of feline teeth and anatomy of the human hand, seemingly innocuous surface bites can seed infections in deeper structures of the hand that can result in adverse outcomes. We report on a case of a rare complication of a flexor tendon rupture that occurred well after the initial treatment of a superficial infection.
A healthy 61 year old male presented to the emergency department with concerns for possible infection after sustaining a cat bite to the proximal phalanx of his left long finger 48 hours earlier. The patient was treated for suspected cellulitis and underwent irrigation and debridement within 36 hours. Five months after presentation, it was determined that the patient had suffered a spontaneous rupture of the flexor digitorum profundus tendon of the left long finger. The patient underwent surgical debridement, flexor tendon tenolysis, and tendon reconstruction. Postoperatively, the patient returned to normal activities with good function of his left hand after a course of occupational therapy.
The purpose of this case report is to describe the clinical course of a patient with the rare complication of a flexor tendon rupture after being bitten by a cat, as well as to review the current literature and treatment for feline bite-related hand injuries. We recommend patients who have sustained a cat bite with a suspected infection to present as early as possible for an evaluation by a medical professional, early appropriate empiric antibiotic administration, and early surgical debridement when warranted to help prevent complications.
猫咬伤是急诊科常见的一种损伤。由于猫牙齿的形态和人手的解剖结构,看似无害的表面咬伤可能会在手部深层结构引发感染,从而导致不良后果。我们报告一例罕见的屈肌腱断裂并发症病例,该并发症发生在浅表感染的初始治疗后很久。
一名61岁健康男性因48小时前左手示指近节指骨被猫咬伤,担心可能感染而就诊于急诊科。患者因疑似蜂窝织炎接受治疗,并在36小时内进行了冲洗和清创。就诊五个月后,确定患者左示指屈指深肌腱发生自发性断裂。患者接受了手术清创、屈肌腱松解和肌腱重建。术后,经过一个疗程的职业治疗,患者左手功能良好,恢复了正常活动。
本病例报告的目的是描述一名被猫咬伤后出现屈肌腱断裂这一罕见并发症患者的临床过程,并回顾当前关于猫咬伤相关手部损伤的文献和治疗方法。我们建议,被猫咬伤且疑似感染的患者应尽早就诊,以便医学专业人员进行评估,在必要时尽早给予适当的经验性抗生素治疗和早期手术清创,以帮助预防并发症。