Because a nail through a single finger is just too mainstream! Treatment of a retained nail following nail-gun injury adheres to standard principles of wound management. A single dose of intravenous or intramuscular antibiotics is often administered, usually a first-generation cephalosporin to cover skin flora contamination in uncomplicated cases. Regional blocks are usually sufficient for wound exploration and debridement. The wound and surrounding soft tissues are thoroughly irrigated with or without the addition of antimicrobial agents. Exploration for removal of foreign material and to avoid secondary injury from nail extraction should be considered. Follow us at @Medicalpedia for more exciting cases!