Violin Spider Bite

Few spiders are dangerous, but the Violin spider has a cytotoxic venom which causes skin necrosis and requires urgent surgical intervention. Bryan was bitten on his left index finger by a Violin spider in June 2017 whilst working in his garden. At first he noticed two small fang marks. Within 24 hours, his finger was swollen, red, painful and bleeding. After 3 days the skin became necrotic and 3 operations were needed to remove all the damaged tissue. Bryan presented to Hand Therapy once the wounds had healed and scar tissue had formed. He was unable to make a full fist because of the tight scar tissue. A variety of hand therapy techniques were used to mobilise the joints and improve the scarring. Once it became apparent that traditional therapy was not working and multiple treatment sessions were required, we began to use the Casting Motion to Mobilise Stiffness Technique (CMMS). This technique involves the use of a plaster of paris cast that selectively immobilizes the joints that are moving well and facilitates movement of the stiff joints. The cast was worn until Bryan could achieve a full fist, which took 3 weeks. Bryan is now focusing on improving grip and pinch strength and continues to improve the functional use of his hand through everyday activities.