![]() ![]() ![]() A small incision over the anaesthetised skin exposes the barbed tip. The advance and cut method is used successfully in almost all types of barbed hooks ( 7) (as in our case). (The deep branch of the ulnar nerve passes between the abductor digiti minimi and flexor digiti minimi). The close association of ulnar nerve in the Guyon’s canal also makes the removal risky. Further hypothenar muscles including the abductor digiti minimi, flexor digiti minimi brevis and opponens digiti minimi were all at risk of injury which is important for the normal functioning of hand especially gripping in the dominant right hand. Several attempts of removal had been made by his relatives causing more soft tissue trauma. Two important aspects of our case were the neurovascular risk of deep branches of the ulnar nerve and artery and continuation of the ulnar bursa to the wrist and distal forearm respectively. However in their technique the barb was not cut as it was easily disengaged by slight rotation which was possible in the first web space of the hand. discouraged home removal of fish hooks by unqualified persons in a single case report ( 6). (2013) emphasized the management of injuries caused by barbed hooks but showed his method on only two cases ( 5). Being a blind procedure, its use for deeply embedded hooks in high risk neurovascular areas cannot be guaranteed. The needle cover technique can be effectively applied for superficially embedded barbed fishhooks. Furthermore, in areas where the risk of damage to vascular structures is greater, this technique cannot be applied. However, its effectiveness on deeply embedded barbed hooks is questionable. Cooke ( 4) described how to remove fish hook with a string which has undergone lot of modifications till now. The string pull technique is the modified retrograde technique with the advantage of being less traumatic to soft tissues, and does not need another exit site. ![]() ( 3) in a study on 100 patients found the retrograde technique useful in only 40 patients. ![]()
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