The patient is caught on a sharp splinter (usually wooden) and either cannot grasp it, has broken it trying to remove it, or has found that it is too large and painful to remove. The history may be somewhat obscure. On examination, a puncture wound should be found with a tightly embedded sliver that may or may not be palpable over its entire length (Fig. 153.1A). There may only be a puncture wound without a clearly visible or palpable foreign body.