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Clenched fist syndrome is defined as keeping one or both hands tightly clenched, and patients with the syndrome have documented evidence of severe anger and poor defense (i.e., a person's inability to protect himself or herself by acting out or other means). Although no organic disease can be found in most cases, patients with cerebral palsy may have this syndrome. The condition is rare, and the progression of the disease is slow. Infections of the hand occur trout a fingernail growing into the palm or from trauma to the joints. These infections usually are caused by mixed aerobic and anaerobic microflora. This article report- two cases ni clenched fist syndrome inun long-term care facilities, which resulted in hand infection.
CASE REPORTS
Case 1
A 40-year-old man with a 10-year history of chronic schizophrenia had a swollen, painful left hand. He had been institutionalized for his psychiatric illness and was able to do most daily activities, with supervision only for medication and meals. His medications included clonazepam, lithium carbonate, atenolol, and diphenhydramine.
Physical examination revealed a withdrawn man who appeared older than his stated age. He responded somewhat reluctantly to questions. His hand was swollen with shiny skin over the knuckle, and his fingernails were long and grown into the palm (Figure 1). There were signs of cellulitis, and pain was...