Eighty-seven cases of a nail gun injury to the extremity.

OBJECTIVES: The aims of this research were to characterise the injury patterns associated with nail guns, highlight their potential complications and review treatment options.

METHODS: A retrospective case series was conducted of all patients with a nail gun injury to the upper or lower limb who presented to the Princess Alexandra Hospital from 1 January 2007 to 30 July 2012.

RESULTS: Young men in the work environment were at most risk of sustaining a nail gun injury to their non-dominant hand. Out of 87 cases identified, 29% were intra-articular, 16% had evidence of neurovascular injury, 24% involved bone and 37% had evidence of tendon injury. Fifty-eight per cent underwent operative management, 32% were treated solely in the ED and 10% were transferred to a private facility. At the time of operation, 14% of cases had tendon, joint or neurovascular involvement and 20% had retained foreign material. The median length of operation was 17 min and no anaesthetic complications were identified. Four (13%) patients had ongoing pain, paraesthesia or stiffness at the time of follow up.

CONCLUSIONS: The present study characterises the injury patterns caused by nail guns. Treatment of these injuries should be based on clinical findings; however, the majority of cases should undergo surgical treatment. The required operation is a short and safe treatment modality that might allow a thorough assessment of the injury, removal of embedded material, repair of structural damage and a sterile washout to be performed.