Twisted Minds, Tangled Fingers: Surgical Rescue from Impacted Bolts.

Introduction: Self-inflicted injuries in psychiatric patients are quite common; however, deep impaction of foreign bodies such as bolts is exceedingly rare. Foreign body impaction injuries in fingers pose a significant risk of skin and deep tissue damage, leading to infection and bone exposure if left unattended. Case Report: A 20-year-old psychiatric male patient presented with severe pain, swelling, and restricted movement of index and ring fingers of his right hand following self-insertion of bolts into the fingers. Clinical examination and radiographic imaging revealed deeply embedded metallic bolts within the soft tissues of the affected fingers. Management involved careful removal of the impacted bolts through cutting, thorough debridement and subsequent reconstruction by local skin flaps to restore finger functionality and appearance. Conclusion: This case emphasizes the importance of prompt diagnosis and management of foreign body injuries to prevent morbidity associated with deep tissue damage and bone erosion. It emphasizes the effectiveness of a combined approach of bolt excision, aggressive debridement, and skin flap reconstruction in treating such severe injuries. It offers broader clinical insights into managing severe foreign body injuries and enhances our understanding of the potential complications associated with delayed intervention in such cases.