Nail guns have been in use since the 1950s.1 Low-velocity nail guns, used on wooden surfaces, are pneumatically driven, and high-velocity ones, which fire single nails or bolts into concrete or metal surfaces, use an explosive cartridge. Nail guns have a ballistic potential comparable to that of conventional firearms, being capable of firing projectiles at speeds of 100–150 m/s and distances of up to 500 m.2
The anatomical location of a nail-gun wound, in combination with radiographs of the nail before its removal, are important for distinguishing cases of accidental and intentional injury in forensic investigations.3 Radiographs indicating a bent-nail are suggestive of accidental injury from a nail ricochet.4 Straight-nail injuries, especially in the extremeties, also usually represent straightforward industrial accidents.5 Straight-nail injuries to people other than the nail gun operator also occur when a nail over-penetrates a surface, often passing through a wall and striking a worker in an adjacent room. Suicide should be considered for straight-nail wounds to the chest, head or abdomen, as many completed suicides reported in the literature have involved wounds to these locations.6
Apart from indicating that a nail may have ricocheted, radiography can identify additional foreign bodies buried in the wound, such as debris from the explosive charge and fragments of the copper wires that string together pneumatically driven nail chains.7
Children have been injured directly by nail guns3 and indirectly by their explosive cartridges. Reports exist of adolescents being injured after finding cartridges lying around construction sites and detonating them with tossed bricks.8 Such incidents underline the importance of operators storing and securing nail guns and cartridges as responsibly as they would any firearm and ammunition.
A MEDLINE search with the terms “nail gun” and “injury” identified a case report of a young French soldier in whom encephalopathy and seizures developed.9 The recruit was found to have tungsten toxicity (detected by testing samples of his hair and nails), which resulted from his drinking a mixture of beer and wine from a hot gun barrel. The CMAJ editors are in agreement that such a practice, like tossing bricks at nail-gun cartridges, is unwise.
Eric Wooltorton Editorial Fellow CMAJ
Footnotes
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References
- 1.Lee BL, Sternberg P. Ocular nail gun injuries. Ophthalmology 1996;103:1453-7. [DOI] [PubMed]
- 2.Beaver AC, Cheatem ML. Life-threatening nail gun injuries. Am Surg 1999;65(12):1113-6. [PubMed]
- 3.McCorkell SJ, Harley JD, Cummings D. Nail-gun injuries. Accident, homocide, or suicide? Am J Forensic Med Pathol 1986;7(3):192-5. [DOI] [PubMed]
- 4.Nadesan KA. Fatal nail gun injury — An unusual ricochet? Med Sci Law 2000;40(1):83-7. [DOI] [PubMed]
- 5.Kenny N, O'Donaghue D, Haines J. Nail gun injuries. J Trauma 1993;35(6):943-5. [DOI] [PubMed]
- 6.Opeskin K, Cordner S. Nail-gun suicide. Am J Forensic Med Pathol 1990;11(4):282-4. [DOI] [PubMed]
- 7.Freeman BJC, Ainscow DAP. Nail gun injury: an update. Injury 1994;25(2):110-1. [DOI] [PubMed]
- 8.Paton RW. Injuries from nail gun cartridges: a dangerous new game. BMJ 1986;293:598. [DOI] [PMC free article] [PubMed]
- 9.Marquet P, François B, Lotfi H, Turcant A, Debord J, Nedelec G, Lachatre G. Tungsten determination in biological fluids, hair and nails by plasma emission spectrometry in a case of severe acute intoxication in man. J Forensic Sci 1997;42 (3): 527-30. [PubMed]