Figure Legend: Clenched fist bite injuries of the metacarpal head or proximal phalanx are highly contaminated, often deeply penetrating wounds with bone involvement.  They are at particular risk for the development of septic arthritis and osteomyelitis.this patient developed osteomyelitis of the proximal phalanx following such an injury, and received inadequate surgical and antibiotic treatment due to neglect. The image on the left shows a healed wound and a draining sinus, and arrows on the right show periosteal bone formation and erosions due to osteomyelitis.  This eventually resulted in amputation.
 

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