Nail Gun Injury

While on the job, a 24-year-old construction worker accidentally shot a nail through his right index finger with a nail gun. Roentgenographic studies revealed no damage to the bone. No neurovascular deficit was noted on examination.

Ridges in the nail's shaft prevented its being pulled out along the same route it went in. Thus, the patient was given digital block anesthesia, the head of the nail was cut off, and the nail was pushed all the way through and out of the finger.

A prophylactic oral antibiotic and a tetanus toxoid injection were given. Healing was uneventful, and the finger remained functional.