A surgeon has revealed the unique things he's removed from people's hands - including sea urchin spines, fishhooks and bullets.<br /><br />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.<br /><br />The hand specialist shared a list of recent things he's removed from hands.<br /><br />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.<br /><br />He has also removed sea urchin spines after a patient fell onto one of the creatures - leaving spines embedded as far as the bone.<br /><br />Nick also removes other things such as gangrene-infected fingers, BB gun pellets and electrical wire.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />"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.<br /><br />"In terms of things I've removed - everything, but now and then something will surprise me.<br /><br />"I had one guy with a snake bite, which can make the whole hand swell up like a balloon.<br /><br />"Another one is the high-pressure paint injuries when someone sprays paint with a high-pressure gun.<br /><br />"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.<br /><br />"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.<br /><br />Before removing the object, Nick has an extensive routine which he undertakes in order to locate it.<br /><br />He uses a strong x-ray and MRI and sometimes also uses an ultrasound to accurately locate the object.<br /><br />Most of his surgeries take as little as 30 minutes, however, he often does finger amputations and re-attachments, which he says can be 'challenging' and time consuming.<br /><br />He said: "I did one where I replaces someone's thumb with their big toe.<br /><br />"It took 12 hours and can be very tricky because the size doesn’t always match up.<br /><br />"If you mess it up and the blood vessels don’t work properly then it can lead to a bad outcome.<br /><br />"Thankfully, this one was successful.<br /><br />"That was probably the most challenging. To take one part of the body and move it somewhere else.<br /><br />"I also had one that was done from a Samurai sword that took off three of his fingers and it took 10 hours to re-attach all the nerves, the tendons and the bones."<br />
