Doctors save life of man shot with 2 inch nail on head with industrial gun

CHENNAI: A 23-year-old daily wage migrant worker experienced a sudden and intense pain at the back of his head while cleaning the floor at his workplace in a private firm in Navalur. He suddenly had blood flowing from the back of his head but unbearable pain but couldn't find why was he bleeding. He was informed that a 2-inch nail from an industrial gun had accidentally struck his head by a coworker who was using the nail gun for a carpentry job.

After being taken to a hospital, doctors recommended an emergency surgery to remove the nail from his head. He was referred to Rela Hospitals for immediate surgery. Upon reaching the hospital, he did not have any weakness in his hands or legs, and his blood pressure and pulse were normal. To prevent any movement of the nail, his neck was immobilized using a hard collar.

“After examining the X-ray, CT scan of the craniovertebral junction, along with a CT angiogram, was also scheduled. During the CT imaging, it was observed that the 2-inch nail was not a simple one, but rather had shanks and additional attachments designed to prevent easy removal once it is hammered into wood. The images revealed that the nail was positioned just above the left vertebral artery, indicating that damage to the vessel could be life-threatening," said Dr M Anbuselvam, senior consultant of neurosurgery, Rela Hospital.

Unlike the usual procedure of inserting an endotracheal tube through the mouth, which involves bending the neck backward, an alternative method using a fiber optic approach was employed. It was then discovered that the nail had penetrated the occipital bone and was lodged firmly. "With caution, a diamond burr was used to gently drill around the nail and create space. The shanks of the nail were exposed, and further delicate drilling allowed for the nail's gentle extraction. There was no bleeding, and the wound was closed successfully," added Dr M Anbuselvam.

The doctors said that it was an extremely complex and a very complicated surgery and doctors had to ensure there were no further damage to the spinal cord and other nerves. Shortly after the surgery, the patient regained consciousness, he remained alert, and was able to move his hands and legs without any difficulty. The very next day, he could move around and was discharged on the 2nd day.