Introduction: Fishing is a common recreational activity among the children and young adults all over the world. This study was done to determine the efficacy of various techniques used for fish hook removal, the anatomical areas involved in fish hook injuries, type of injuries, types of analgesia used, need for tetanus prophylaxis and complications associated with fish hook injuries.
Methodology: This was a single-center retrospective study based on data collected at the Children’s Emergency department at KK Women’s and Children’s Hospital (KKH) between 2006 and 2016.
Results: There were 37 fish hook injuries in the study period. Puncture wounds (81.1%) caused by fish hooks were the most common type of injuries seen followed by lacerations (18.9%). Advance and cut technique of fish hook removal was used in 70.3% of patients with retrograde removal technique being used in remaining patients. 13.5% patients developed features of wound infection requiring interventions like wound toileting, change in antibiotics and multiple follow up visits for wound care.
Conclusion: Our study demonstrated that the predominant types of injuries associated with fish hook are superficial injuries like puncture wounds and lacerations. Bystander use of fish hook resulted in majority of injuries in children. Advance and cut technique of fish hook removal was the most common type of method used for fish hooks removal and had the highest success rate. The commonest complication related to fish hook injury is infection and this occurred despite the use of prophylactic antibiotics in all the patients.
Keywords: Fish Hook Injuries; Children
Fishing is a common recreational activity among the children and young adults all over the world . Fish hook injuries can occur while casting the hook into the river or pond, while grasping the hook to attach bait or while trying to retrieve the hook from the fish [1-3]. Injuries to foot can occur while walking bare footed near the fishing areas. The uses of barbed fish hooks have become popular because of the anticipated increased efficacy in retaining the catch . Fish hooks can be classified as single barbed fish hooks and multiple barbed fish hook . Fish hook related injuries have been described in various anatomical areas like hands, face, eye, lower limbs, oral cavity and back [3,5]. Management of fish hook related injuries should begin with a focused history followed by careful examination of the wound and the surrounding tissues [2,6]. A specialist opinion should be sought at the earliest in case of complex wounds involving eye and suspected injury to underlying blood vessels, nerves or tendons  because the external injuries can look deceivingly minimal .
There are five techniques that can be used for removing fish hooks embedded in the tissues. These include simple retrograde technique, string-pull technique, needle cover technique, advance and cut technique (for single barb and multiple barb fish hooks) and cut-it-out technique [3,5,6] (Figures 1-5). The choice of technique depends on the type of fish hook embedded, anatomical location of the injury, depth of injury and the experience of the treating physician [6,7]. Retrograde technique and string-pull method are associated with the least trauma during removal and is generally used for removal of simple hooks without barbs . The presence of multiple barbs can make the removal of the embedded fish hook difficult due to entanglement into the vital underlying anatomical structures .This study was done to determine the anatomical areas involved in fish hook injuries, type of injuries, the efficacy of various techniques used for fish hook removal, types of analgesia used, prevalence of antibiotics use, need for tetanus prophylaxis and the complications associated with fish hook injuries.