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


  • Shi-Neng James Ling, MBBS, MPH, Principal House Officer; Natalie Chuen-Ying Ong, BSc, MBBS, Junior House Officer; John Bevan North, MBBS, FRACS, Orthopaedic Surgeon.



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


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.


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.


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.