Review of 88 nail gun injuries to the extremities

Background: Nail guns have been employed since 1959 to speed construction work, but with the increased productivity came an increasing number of injuries associated with the device. The majority of reported cases occur to the extremities. Methods: Our study retrospectively examines 88 cases of nail gun injuries to the extremities collected from a 4-year period. Radiographs and charts were used to collect data on anatomic site, type of treatment, type and duration of antibiotic treatment, and outcomes. Results: We found that infections associated with nail gun injuries were relatively rare (n = 3) and in our study were limited to those patients who presented later than the day of injury. The majority of injuries were to the hand and knee (38.6% and 28.1%, respectively). No significant vascular or neurological injuries were encountered. Conclusions: It appears that simple emergency room removal of the nail with local debridement and a short course of antibiotics is appropriate in most cases. The exception to this is where there is intra-articular or neurovascular involvement, then operative debridement is recommended.