EP-216 Case Report: A Fishy Case of Flexor Tendon Injury

Abstract

Abstract Introduction We describe the first documented case of a flexor pollicis longus (FPL) tendon injury occurring secondary to a fish bite. Case Report A 52-year-old right hand dominant male was referred with inability to flex his right thumb following a pike bite whilst fishing in a nearby Loch. Clinical examination revealed superficial abrasions to his right thumb with two deeper puncture wounds over the volar pulp. He had no active flexion of the interphalangeal joint. Radiographs showed no fracture/foreign body. Given deep animal bite, intravenous antibiotics and operative exploration were indicated. Intraoperative findings revealed 100% division of the FPL tendon (zone II); this was repaired using a modified Strickland method. The patient completed 48 hours intravenous antibiotics and was discharged with physiotherapy-led follow up. Discussion Animal bites are a common presentation to the Emergency Department however non-domesticated animals account for <5% cases. We are not familiar with managing marine animal bites and the literature is lacking. Only 2 cases of sting-ray injuries have been described, both of which were associated with delayed presentation and poor functional outcome. Aquatic injuries also contain unique bacterial flora including Vibrio, Aeromonas and Pseudomonas which merits consideration. Conclusion This case highlights the importance of managing innocuous wounds with caution in case of underlying structural damage. Unusual animal bites should be closely monitored with low index for surgical exploration to avoid delayed complications. Discussion with microbiology specialists should also be considered.