Management of a Muskellunge Fish Bite to the Thumb With Subsequent Flexor Tendon Laceration

Despite frequent occurrences, especially throughout the Appalachian region, fish bite injuries remain largely underreported. Muskellunge anglers are at a particularly heightened risk due to the fish's large mouth and notably sharp teeth. We present a case of a male who sustained an injury to the right volar thumb following a muskellunge bite. Notably, the patient denied pain and tenderness following the incident, but had an inability to flex the interphalangeal joint. Following exploration, the patient underwent irrigation, debridement, and repair of a flexor pollicis longus tendon laceration. Subsequently, the patient required occupational therapy to improve range of motion, and antimicrobial therapy for surgical prophylaxis. Themedical and surgical management of each fish bite injury undoubtedly represents a unique clinical puzzle for healthcare professionals that is dependent upon the severity of the bite, regional anatomy involved, and time course in seeking treatment. Creating a record of notable identified cases in the scientific literature could be pertinent for treatment of patients with similar presentations.