Twenty-four cases of osteomyelitis of the hand after human bite were r
eviewed. The mechanism of injury was equally divided between incisor b
ites and clenched fists. Eleven of twelve of the clenched-fist injurie
s showed a tooth mark in the bone or cartilage at the site of inoculat
ion. The incisor bites showed initial infection of the soft tissues or
joint with a secondary infection of the bone. Factors leading to the
development of osteomyelitis included a delay of more than 24 hours be
fore debridement or inadequate initial treatment. Bacteriologic study
commonly showed mixed infections with skin and oral flora. The infecti
ons were prone to relapse, and nine patients required more than one su
rgical debridement.