High pressure injection injuries

Abstract

High pressure injection injuries are infrequent occurrences but their innocuous appearance leads to underestimation of their severity and results in significant morbidity. A good history and early referral of these injuries to a hand surgeon may help in reducing this morbidity. The nature of the substance injected (its volume, viscosity and toxicity), its site of injection and distribution of spread, the pressure of injection and delay to surgical debridement are all believed to be factors that contribute to the outcome of these injuries. Early surgical debridement should be the mainstay of treatment of these injuries. Any decision to treat these injuries nonoperatively should be made by an experienced hand surgeon and is only appropriate in selected cases. Most patients will require postoperative hand therapy, will experience a prolonged time to healing and will be left with long term motor and sensory deficits.