Which Medical Specialty to Consult for Embedded Thorn in Finger? - Surgery

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When dealing with an embedded thorn in the finger, especially when it has been present for an extended period and is causing pain, it is crucial to consult the appropriate medical specialty to ensure proper diagnosis and treatment. Given your situation, where the thorn is not visible on the surface and has not been successfully located by dermatologists or orthopedic specialists, the best course of action would be to consult an Orthopedic Surgeon or a General Surgeon.


Why Orthopedic or General Surgery?
1. Expertise in Soft Tissue Injuries: Both orthopedic and general surgeons are well-trained in handling soft tissue injuries, including foreign body removal. They have the skills necessary to explore deeper tissues if the thorn is embedded beneath the skin.

2. Advanced Imaging Techniques: While X-rays may not detect non-metallic foreign bodies, surgeons often have access to advanced imaging techniques such as ultrasound or MRI, which may help locate the thorn more effectively.

3. Surgical Intervention: If the thorn is indeed embedded and cannot be removed through non-invasive means, a surgeon can perform a minor surgical procedure to extract it safely. This is particularly important if the thorn is causing ongoing pain or risk of infection.


Other Considerations
- Dermatology: While dermatologists are specialists in skin conditions, they may not have the tools or experience to deal with embedded foreign bodies effectively, especially if they are not visible. However, if you have concerns about skin reactions or infections, a dermatologist can still provide valuable insights.

- Plastic Surgery: If there is significant damage to the surrounding tissue or if the thorn has caused complications that affect the appearance or function of the finger, a plastic surgeon may be involved in the repair process. However, this is typically a secondary consideration after the thorn is removed.

- Family Medicine: A family physician can provide initial assessment and referrals but may not have the specialized skills necessary for foreign body removal.


Recommendations
1. Seek an Orthopedic or General Surgeon: Given your symptoms and the history of unsuccessful attempts to locate and remove the thorn, I recommend making an appointment with an orthopedic surgeon or a general surgeon at a reputable hospital, such as National Taiwan University Hospital or Linkou Chang Gung Memorial Hospital.

2. Prepare for the Appointment: Bring any medical records from your previous consultations, including notes from the dermatologists and orthopedic specialists. This information will help the surgeon understand your case better.

3. Discuss Imaging Options: Ask about the possibility of advanced imaging techniques that could help locate the thorn before any surgical intervention.

4. Monitor Symptoms: Keep track of any changes in symptoms, such as increased pain, swelling, or signs of infection (redness, warmth, discharge), and report these to your healthcare provider.


Conclusion
In summary, for an embedded thorn in your finger that has not been successfully located or removed, consulting an orthopedic surgeon or a general surgeon is the most appropriate course of action. They have the expertise and resources to address your condition effectively, ensuring that you can return to your normal activities without pain.