Ask a Doctor: Splinters, Slivers, and Foreign Bodies
Splinters, slivers, and other material in the hand may be a simple problem, but they can also need treatment by a doctor and, in special circumstances, a hand surgeon. A hand surgeon is a doctor who specializes in treating conditions, such as foreign bodies, that affect the hand and upper extremity. They can provide expert advice and treatment if necessary.
In this article, hand surgeon Jeffrey C. Wint, MD from the Hand Center of Western Massachusetts answers your questions about splinters, slivers, and other foreign bodies.
What is a retained foreign body?
Retained foreign bodies are objects that become lodged in the body and are not removed. Foreign bodies in the hand can cause injury and can lead to infection or other complications if they are not removed. Most retained foreign bodies are small. A typical foreign body that is found in the hand is a wood splinter, a thorn, or a metal sliver, however thorns and other plant or animal barbs such as sea urchin spines are also possible. Many times, a superficial foreign body can be found during physical examination by a hand surgeon and removed without difficulty.
Can some foreign bodies in the hand be removed without seeing a doctor?
Yes. Some small, superficial foreign bodies in your hand can be removed without seeing a doctor, and they should be removed as soon as possible to prevent infection or further injury. To remove a splinter, you will need a pair of tweezers, a sterilized needle, or a splinter remover tool. First, clean the area around the splinter with soap and water to reduce the risk of infection. Then, use the tweezers, needle, or splinter remover tool to gently remove the splinter. If the splinter is deep, you are unable to remove it yourself, it appears to be infected, or if you have any other concerns, you should see a doctor or hand surgeon. A hand surgeon will have the tools and expertise to remove the splinter safely and effectively.
How do I know if it’s safe to remove the splinter myself?
Attempting to remove a deep splinter yourself can be dangerous and can cause the splinter or foreign body to break, making it even harder to remove. Consult a doctor if you are seeing any of these signs near the area of the foreign body, which may indicate that a splinter is too deep for home removal:
- Altered sensation
- Tingling
- Signs of color changes
- Swelling
- Throbbing
- Loss of motion or catching when the hand or finger is moving
Can splinters in the hand be dangerous?
All splinters have the potential to be dangerous if they are not removed properly. Splinters that are left in the skin can cause infection, inflammation, and other complications. Some types of splinters are more likely to be dangerous than others. Splinters from certain types of wood, such as poison oak or poison ivy, can cause an allergic reaction. Splinters from glass, metal, or other sharp objects can also cause more serious injuries, such as cuts or puncture wounds. If you are unsure whether a splinter is dangerous, it is best to see a doctor for removal.
Splinters and slivers can sometimes cause trauma to the skin, and it is possible for them to contribute to the development of an inclusion cyst. What may have begun as a small inert splinter can now be a hard lump that grows and grows as the body layers more tissue around it. Inclusion cysts can develop from blocked hair follicles or sweat glands, and they can also be caused by other factors such as infection or inflammation. The hard lump itself is annoying and the removal will now include the offending foreign body and the cyst or mass of tissue itself.
There are some tools your hand surgeon may use to detect a foreign body in the hand, including:
- X-ray: X-rays can be used to detect some wood splinters in the hand if there is a subtle shadow, and they are much better at detecting metal slivers. Glass typically only shows on an x-ray if it is leaded.
- Ultrasound: An ultrasound can be used to detect the location and size of the object.
- CT scan or MRI: These imaging studies can be used, but they are rare and only used in severe cases.
Can my foreign body come out on its own? What happens if it stays?
Yes, a foreign body can potentially come out on its own if it was superficial. This is called spitting. Foreign bodies that are deeper below the skin can sometimes sit for years without being noticed. Either it eventually spits, in which the skin pushes it out as it grows, or it is walled off by tissue in an area that you never notice. This is not always the case, so you should consult with a hand surgeon if you think there may be a splinter or sliver stuck beneath your skin.
Dr. Wint is a hand and orthopedic surgeon in private practice at The Hand Center of Western Massachusetts. He is an Adjunct Assistant Professor of Surgery at UMass Chan Medical School in Springfield, MA and is affiliated with several regional hospitals, including Baystate Medical Center and Shriners New England.