Snakebites of fingers or toes by Viperidae family members : An orthopaedic approach

Published online: Apr 27 2011

Marios G. Lykissas, Panayiotis Koulouvaris, Ioannis Kostas-Agnantis, Ioannis Gkiatas, Haralampos J. Milionis, Alexandros N. Mavrodontidis

From University of Ioannina School of Medicine, Ioannina, Greece


The purpose of this study was to review current principles of therapy for affected patients and determine whether an emergent surgical approach or expectant management should be selected in cases of snakebites of fingers or toes by Viperidae family members. Over the past five years (January 2004 to December 2009), 12 patients bitten by Vipera ammodytes were admitted in our department. We retrospectively reviewed their demographic and epidemiological characteristics as well as their symptoms, laboratory findings, and complications. All snake bites occurred at the extremities (fingers and toes). The main complications were oedema, disseminated intravascular coagulation, and decrease in haematocrit. None of the patients developed compartment syndrome or required surgical debridement. The majority of the patients with snakebites of fingers or toes by Vipera ammodytes can be treated conservatively. Surgery is indicated only in case of compartment syndrome, where fasciotomies should be performed without delay after diagnosis.