CHAPTER 16 Fishhook Removal
Fishhook injuries are relatively common. Confidence in their management is paramount to successful outcomes. The method used to remove a fishhook depends on the anatomic location of the injury and the conditions under which the removal is to take place. The first and least harmful method described is the string-yank method, which may be used without anesthesia by anglers on the water. It is best used on the more resilient skin surfaces with underlying bone and muscle. For more embedded hooks, or for hooks in flaccid areas such as the earlobe, the needle cover “barb-sheath” or the pull-through technique may be more applicable. Local anesthesia with 1% lidocaine is well received by the anxious patient in an emergency setting. If the shank has already been clipped by a well-meaning first-aider, a strong needle driver or hemostat may be clamped over the exposed shank tip to facilitate removal.
Occasionally, radiographs may help in determining the type of fishhook and depth of penetration. Before a fishhook is removed, be sure to assess the proximity of the hook to underlying neurovascular or tendon structures and the potential for damage.