Fixed dental brace band in a fight bite injury: a case report

A 23-year-old, right-hand-dominant man presented to our unit having sustained a fight bite injury to his ring finger metacarpophalangeal (MCP) joint. He was listed for exploration and washout of the injury under regional anaesthesia, as performed by the senior author. During exploration, the joint capsule was found to be breached and on further inspection a small, clear plastic ring was identified in the volar or palmar aspect of the joint, immediately above the volar plate. The ring looked like a dental brace band and as the patient was awake, he was questioned whether the recipient of the blow had been wearing dental braces, and this was confirmed to be so. The fixed dental brace is made of brackets attached to the teeth, an archwire linking them and held together with rubber ligatures or dental brace bands (Figure 1). These rubber bands are available in many colours, although they are often transparent to minimize the visual impact of the brace (Figure 1). Due to its small size and transparent nature, this was something that the senior author felt could have been easily missed during the surgery (Figure 2). It is well known that the metacarpal head can be damaged by an opponent’s teeth when assaulting someone with a clenched fist position. Plain radiographs are often used to detect tooth foreign bodies or osteochondral defects in the metacarpal head (Eyres and Allen, 1993), but