Os autores informam que não há conflito de interesse.
Manoel Francisco de Campos Neto (1)
Jorge Paulete Vanrell (2)
Vicente Palmiro Silva Lima (3)
Luis Marcos Turdera (4)
Vidal Haddad Junior (5)
(1) Official Medical Examiner – POLITEC – Legal Medicine Section – Cáceres-MT Regional and Traumato-Orthopedist of the TRAUMA and EMERGENCY team of HRAF- Antonio Fontes Regional Hospital – Cáceres – MT – (manoelcamposneto60 @ gmail .with). (2) Doctor of Science; Former Medical Doctor of the Superintendent of the Technical-Scientific Police of the Secretariat of Public Security of São Paulo, Professor of Legal Medicine at the Paulista University Law Course (UNIP); Professor of the Master’s Degree in Legal Medicine at the University of Valencia (Spain); Professor of Legal Medicine and Criminology at the Civil Police Academy of São Paulo. (3) Traumato-Orthopedist of the Trauma and Emergency team of the Regional Hospital of Cáceres-MT. (4) Labor and Traumato-Orthopedist Judicial Expert of the Trauma and Emergency team of the Regional Hospital of Cáceres-MT. (5) Professor of Dermatology – Universidade Estadual Paulista – UNESP – Botucatu / SP.
INTRODUCTION: Equidae bites can be highly destructive, causing laceration and amputation of body segments. CASE REPORT: A 26-year-old male patient was transporting cattle between the municipalities of Jauru and Comodoro (Mato Grosso State, Brazil). During the rest stops, he and his brother were assigned to tame some wild donkeys (“burros-chucros”) that were with the cattle. At one of these intervals, when he took his hand to attach a rope to the bridle connected to the animal’s mouth, he was violently bitten in his left hand, and when he pulled it, his thumb was severed. Feeling intense pain, the victim and brother made a compressive bandage and sought medical help, taking the amputated finger. The patient was attended in Jauru town and referred to the Regional Hospital of Cáceres town. Preoperative assessment: examined more than sixteen hours after the accident, it had the first quirodactyl amputated / crushed at the base, with remaining fragments of muscle tissues and tendons contaminated by grass and soil. There was a fracture of the proximal phalanx, with local cyanosis. The muscular, vascular and neural structures were exposed and lacerated, causing abundant bleeding. The high degree of destruction (short-cut wounds, macerated and irregular borders) and contamination, discarded the possibility of reimplantation. The radiographic study revealed a fracture in the medial-proximal 1/3 of the 1st phalanx of the left thumb. Surgical Report: after an abundant washing of the hand and forearm with antiseptics and saline solution, pneumatic garrote was applied. Next, excision of the devitalized tissues and identification of the reusable structures were performed. The pedicled skin flap worked as a biological dressing. Internal sutures cooperated to cover the bone. Small incisions were made for spontaneous drainage and better adherence of the graft during healing. Post-operative: made use of antibiotic therapy, anti-inflammatory, analgesic and anti-tetanus serum. After a few days, the patient was discharged from the hospital. CONCEPTUAL POINTS AND SYNTHESIS: Wounds from wild donkeys “burros-chucros” are rare. In this case there was amputation / pulling of the left thumb, probably due to the victim’s defense mechanism at the moment of the bite. As the victim worked at that moment, an occupational accident was set up.
REFERENCE:
Campos Neto, MF, Paulete Vanrell.J., Atlas of Legal Medicine – Practical Guide for Doctors and Law Enforcement Operators – Volume II – Animal Injury (p.263-265) -1 Ed, LEUD Publishing House, 2014.
