Percutaneous Removal of a Foreign Body From the Distal Phalanx Using a 14 Gauge Needle and Fluoroscopy

The hand is essential in many aspects of daily life, making it particularly vulnerable to injury. One of the more common injuries is foreign bodies, which represent 10% of hand injuries.1 While typically people can remove the foreign body on their own, occasionally they may require surgical attention. Retained foreign bodies can lead to infection, migration, pain, stiffness, and discoloration of the above nail or skin. Surgical removal can be time consuming and invasive. Often the dissection and removal can be more morbid than the retained foreign body. Particularly in the case of foreign bodies in the distal phalanx, determining the best approach can be difficult. Both the dorsal and volar approach have significant drawbacks. In a volar approach to the distal phalanx one must transect the pulp and risk damaging a patient's finger pads, which are critical for sensation. A dorsal approach involves dissecting the nail bed, with longer recovery and risks permanent damage to the germinal or sterile matrices.