31/05/2020
Nail-gun injury to the hand!!
Today we would like to show you an orthopedic upper extremity case!!
This patient had a nail gun accident while doing some home repair. As a result he had an impaled nail with entrance and exit wound of his hand!! 🤚🏼
The patient complained of pain, but there were no apparent motor, neurologic, or vascular deficits. Although the range of motion was limited because of retained , there was no indication of tendonous injury.
The nail was removed in the operating room.
Surgical exploration and extraction—with surgical debridement and irrigation—is likely to be necessary for more complicated cases especially if symptoms or signs suggest of nerves, arteries or joints. Adults who have injuries deemed to be tetanus prone should receive a ADT booster, if more than 5 years have elapsed since their last dose.
Most of these workplace injuries occur during routine use and are due to accidental discharge, careless handling of equipment, overpenetration of structures by the projectile, ricochet or shattering of the projectile, and the structural unsoundness of the receiving material.
The majority of injuries involve retained nails with trauma limited to the surrounding soft tissues. Direct bony injuries to the digits, hand, and wrists as well as penetrating injuries to the interphalangeal and radiocarpal joints are the commonest.
Video from .surg.col
