special subjects
Nail Gun Injuries
Introduction
Nail gun injuries, common in the construction industry, are usually puncture wounds on the hands and fingers, but sometimes they result in more serious injuries. Diagnosis is clinical; evaluation requires x-rays. Treatment is surgical. Nail guns, which have replaced hammers in wood-frame construction, cause an estimated 37,000 emergency department visits each year; 68% of them are work-related. Nail guns deliver nails at high velocity, which can penetrate soft tissue and bone. Most nail gun injuries involve the fingers and hand; however, injuries to the lower extremities, trunk, eyes, and head also occur. If the eyes are involved, vision may be lost. (See alsoNational Institute for Occupational Safety and Health (NIOSH): Nail Gun Safety.) In addition to the nail, other materials (eg, wire, fabric, paper, adhesive) can enter the wound during a nail gun injury and lead to infection. Nail guns have been used in suicidal gestures. 