Monday, January 11, 2010
Fish Hook Removal
This 9-year boy accidentally sustained an embedded fish hook injury while having an evening outing with his elder brother.
We took a radiograph of site of hook insertion to see how deep it was before attempting removal because if the point of insertion is relatively superficial to the skin surface, we may decide on retrograde technique.
After reviewing the X-ray, we decided on the traditional advanced-cut through technique, where using a plier, the entire barb is advanced through until the hook is cut through out to the skin surface and then the hook can be cut free into 2 pieces and can be easily removed out. The main disadvantage of this method is that it can cause further trauma to the surrounding tissue.
The other three methods employed including:
- Retrograde technique
- String yank technique (which is almost similar to retrograde technique except that a string, is tied around the midpoint of the hook bend and while, depressing the distal portion of the shank of the hook, a quick firm jerk of the string is applied)
- Needle cover technique, using the needle with the bevelled facing down to engage in the barb and then pull backward.
A very useful article, with ample illustration to facilitate the understanding of all these methods can be found here; the pdf version can be downloaded here.
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