Nail gun inury to first metacarpal

Case contributed by Paul Simkin
Diagnosis certain

Presentation

Nail gun injury.

Patient Data

Age: 40 years

A 6 cm nail enters from the lateral aspect of the left hand, and traverses of the base of the first metacarpal. No fracture is identified. The nail may extend to the proximal articular surface, however there is no evidence of involvement of the adjacent trapezium or second metacarpal. A separate small radiopaque foreign body is seen within the soft tissue of the thumb, at the level of the proximal phalanx.

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