A surgeon has revealed the unique things he's removed from people's hands - including sea urchin spines, fishhooks and bullets.
Nick Pappas, 43, has been a practising orthopaedic surgeon for 10 years and spends his time removing foreign objects, inserting metal plates and re-attaching fingers.
The hand specialist shared a list of recent things he's removed from hands.
First up on the list is screws - with Nick saying he often has to establish the brand of the screw to allow him to use the correct screwdriver to remove it.
He has also removed sea urchin spines after a patient fell onto one of the creatures - leaving spines embedded as far as the bone.
Nick also removes other things such as gangrene-infected fingers, BB gun pellets and electrical wire.
Nick says he's also had to remove snake bit venom, toxic paint from a high-pressure paint gun and what he says is the "most dramatic" - fish hooks.
He decided to work at a private hospital so he would have more freedom and recently started sharing the intricacies of his job on social media.
Nick, from New Orleans, Louisiana, US, said: "I've got a private practice so I can teach and use social media to teach and educate people.
"People are interested to know what it's like if they ever have hand surgery and I'm able to show what it’s like to have a certain operation.
"In terms of things I've removed - everything, but now and then something will surprise me.
"I had one guy with a snake bite, which can make the whole hand swell up like a balloon.
"He'd killed the snake after it attacked him and all the nurses were freaking out because the guy had a snake bite, the container and the dead snake which he'd brought with him.
"Another one is the high-pressure paint injuries when someone sprays paint with a high-pressure gun.
"It can shoot into their hand from their finger all the way to the palm or wrist area and that’s a surgical emergency because the paint can be so toxic.
"It can lead to amputation of the whole hand.
"Other times I see a lot of BB gun pellets and the patients don’t even realise they're in their hand and then show up six months after the incident, complaining of pain.
"I've also seen a lot of gunshots and, if it's a fragment of a bullet inside the bone, I usually leave it alone and observe it over time, but if it’s sticking out of the skin or a full bullet then you remove it.
"In general, surgeons don't remove bullets from the extremities unless they are causing pain, are very superficial, are in a joint, or are pushing on a neurovascular structure.
"Sometimes it can be more harmful to try to take it out than to just leave it in, as long as it's not causing any issues."
Before removing the object, Nick has an extensive routine which he undertakes in order to locate it.
He uses a strong x-ray and MRI and sometimes also uses an ultrasound to accurately locate the object.
Nick Pappas, 43, has been a practising orthopaedic surgeon for 10 years and spends his time removing foreign objects, inserting metal plates and re-attaching fingers.
The hand specialist shared a list of recent things he's removed from hands.
First up on the list is screws - with Nick saying he often has to establish the brand of the screw to allow him to use the correct screwdriver to remove it.
He has also removed sea urchin spines after a patient fell onto one of the creatures - leaving spines embedded as far as the bone.
Nick also removes other things such as gangrene-infected fingers, BB gun pellets and electrical wire.
Nick says he's also had to remove snake bit venom, toxic paint from a high-pressure paint gun and what he says is the "most dramatic" - fish hooks.
He decided to work at a private hospital so he would have more freedom and recently started sharing the intricacies of his job on social media.
Nick, from New Orleans, Louisiana, US, said: "I've got a private practice so I can teach and use social media to teach and educate people.
"People are interested to know what it's like if they ever have hand surgery and I'm able to show what it’s like to have a certain operation.
"In terms of things I've removed - everything, but now and then something will surprise me.
"I had one guy with a snake bite, which can make the whole hand swell up like a balloon.
"He'd killed the snake after it attacked him and all the nurses were freaking out because the guy had a snake bite, the container and the dead snake which he'd brought with him.
"Another one is the high-pressure paint injuries when someone sprays paint with a high-pressure gun.
"It can shoot into their hand from their finger all the way to the palm or wrist area and that’s a surgical emergency because the paint can be so toxic.
"It can lead to amputation of the whole hand.
"Other times I see a lot of BB gun pellets and the patients don’t even realise they're in their hand and then show up six months after the incident, complaining of pain.
"I've also seen a lot of gunshots and, if it's a fragment of a bullet inside the bone, I usually leave it alone and observe it over time, but if it’s sticking out of the skin or a full bullet then you remove it.
"In general, surgeons don't remove bullets from the extremities unless they are causing pain, are very superficial, are in a joint, or are pushing on a neurovascular structure.
"Sometimes it can be more harmful to try to take it out than to just leave it in, as long as it's not causing any issues."
Before removing the object, Nick has an extensive routine which he undertakes in order to locate it.
He uses a strong x-ray and MRI and sometimes also uses an ultrasound to accurately locate the object.
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