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Bite Injuries - Human Bites

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Introduction

Human bite injuries result from fist fighting or the intentional act of biting to inflict harm.  Bite injuries occur during fist fighting if the fist of one person strikes the teeth of another person. 

Hand injuries from human bites can result in lacerations and injuries to the bones, joints, ligaments, tendons, nerves, blood vessels, and muscles. 

Human bites are more dangerous than animal bites because they transmit higher concentrations of infectious bacteria.  Human bites require prompt medical attention.  Hand surgery may be necessary to properly clean wounds, and or to repair structural injuries.

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Anatomy

The hand is composed of many bones that provide structure for your wrist and fingers.  The bones are connected with strong ligament tissues.  Tendons are strong fibers that attach your muscles to your bones and allow movement.  Your hand also contains nerves, blood vessels, and fat.  The skin that covers your hand protects it from the environment.
 
The "knuckles" as they are commonly known, are the metacarpal phalangeal joints of the hand.  Simply put, these are the joints where the hand attaches to the fingers.  These joints are the ones most commonly affected when a tooth causes an injury after a punch in the mouth.
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Causes

Human bite injuries can result from fist fighting or one person biting another.  A penetrating injury can occur if one person’s fist hits another person in the teeth.  If the impact breaks the skin, it is considered a bite injury.
 
Human bite injuries can occur from one person biting the other.  Toddlers may bite each other, but they generally do not cause significant injury.  Bite injuries most frequently occur as intentional acts of violence during child abuse or domestic abuse. 
 
Hand injuries from human bites can result in cuts and injuries to the hand bones, joints, ligaments, tendons, nerves, blood vessels, and muscles.  Human bites are more dangerous than animal bites because they transmit higher concentrations of infectious bacteria.  Additionally, HIV, the virus that causes AIDS, and hepatitis can be transmitted from one person to another by blood and saliva contact. 
 
Human bite bacterial infections are usually caused by a staphylococcus or streptococcus species.  However, Eikenella species are common organisms causing human bite infections.
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Symptoms

A human bite can cause pain and swelling.  It may be difficult for you to move your fingers following such an injury.  You should inspect your hand for puncture wounds and bleeding.  Signs of infection include warmth, redness, pain, tenderness, and a pus discharge.  Infections can also cause a fever, chills or sweats.  Infection can occur rapidly following a human bite.
 
You should contact your doctor if you or your child receives a human bite.  You should carefully wash the wound with soap and water, unless the area is actively bleeding.  If you experience bleeding apply direct pressure and elevate your hand above the level of your heart.  You should go to your doctor or an emergency department for immediate treatment in such instances.
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Diagnosis

You should tell your doctor that you received a human bite.  Your doctor will examine your hand and arm for signs of injury and infection.  An X-ray will be ordered to rule out fractures or indentations of bone caused by teeth.
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Surgery

The type of surgery that you receive depends on the type and extent of your injury.  The goal of surgery is to return your hand structure and function to its pre-injured condition.  Unfortunately, if joint infection from a human bite is not treated promptly, significant functional problems can occur.
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Treatment

Your doctor will carefully wash and remove any foreign substances from your wound.  You may need to get a tetanus shot and antibiotics to fight infection.  Your doctor will instruct you on home care for your wound.  You should make and attend all of your follow up appointments.  If there is risk of the bite entering a joint, you will require surgery to completely wash out the joint.  If infection has already set in, surgical drainage is mandatory, with the wound left open to drain.  Intravenous antibiotics will be necessary.
 
Animal bites that puncture the skin require careful cleaning.  Wounds are usually kept open, instead of stitched shut, to help avoid infection.  If you have an infection, you may receive oral antibiotic medication, antibiotic ointment, or IV antibiotics.  Your wound will be loosely bandaged.  Your doctor will provide you with home care instructions.  It is very important that you attend your follow-up appointments so that your condition can be monitored.
 
You will most likely participate in hand therapy rehabilitation following non-surgical or surgical treatment of your injury.  Your therapist will teach you exercises to help you gain range of motion, flexibility, coordination, and strength.  Therapy will help to reduce swelling, pain, and stiffness.  The extent of hand therapy rehabilitation that you receive depends on your injury and the type of treatment you had.  The goal of hand therapy is to restore the function of your hand.
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Recovery

Recovery from human bites is an individualized process.  Your recovery will depend on the extent of your injury or infection and the type of treatment you receive.  Your doctor will let you know what to expect.  Attend all of your doctor and hand therapy appointments to ensure the best recovery possible. 
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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