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 />"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.<br /><br />"Another one is the high-pressure paint injuries when someone sprays paint with a high-pressure gun.<br /><br />"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.<br /><br />"It can lead to amputation of the whole hand.<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 />"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. <br /><br />"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."<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.
