GREY'S ANATOMY MADE-FOR-TV CASE OF THE WEEK
What happens when a nail gun meets a wrist
A little while back, I got a call from an emergency room with a patient who accidentally shot himself in the wrist with a nail gun.
We get these calls more often than you'd think. Usually, it's just a 'heads up' after the ER removes the nail, and they ask me to check the patient in a week to ensure appropriate healing.
But this day was different. The ER could see the nail on x-ray, but it was nowhere to be found within the wrist. And they didn't want to go digging around blindly (thankfully).
So I go see the guy and, sure enough, there's hardly a trace of the nail. A little puncture wound, but nothing more. However, he does have increasing numbness and tingling in his pinky finger...
Long story short, I take the guy to surgery. Before the operating room, I assured him that projectiles (bullets, nails, etc) have a curious and fortunate habit of bouncing off important structures once they're inside the human body. Meaning they may graze past nerves and blood vessels, but thanks to the physics of projectiles, they will rarely transect or impale said structures.
Well, I ate my words that day.
As I surgically dissected his wrist, I could hardly believe my eyes. There was the brad nail, perfectly skewering the ulnar nerve (the most important nerve in your hand). It could not have been more of a direct hit.
Fortunately, his luck turned around from there. The nail had split its way between nerve fascicles (ie, between the cables that transmit the important stuff) and, once removed, hardly left a trace. I've since seen him back in the office, and his sensation and function have already fully recovered.
A happy ending for all.
Even though I had to eat crow 😂.
