A 10-Year Review of High-Pressure Injection Injuries to the Hand

Abstract

High-pressure injection injuries to the hand are uncommon, but often result in poor outcome or even amputation. We report a review of the 28 cases treated surgically in our department over the last 10 years and have examined the factors leading to increased morbidity. The severity of these injuries was related to the nature of the injected material, involvement of the tendon sheath and proximal spread of the injected substance. All cases in which the digit was noted to be poorly perfused from the outset resulted in amputation. We conclude that early amputation should be considered in cases in which the affected digit is initially cool or poorly perfused.

Hand injuries due to high‐pressure injection devices for painting in shipyards: Circumstances, management, and outcome in twelve patients

“…Delayed surgical treatment may allow the establishment of severe tissue damage whose natural outcome is fibrosis and neurovascular injury [Lewis, 1985] or gangrene, which ultimately requires amputation [Pinto et al, 1993;Stoffelen et al, 1994]. An X-ray should precede the surgical treatment both to detect fractures and to guide the decompression by showing the extent of the spread of the contaminant, which may contain radio-opaque substances.…”

“…Angiographic investigations are also useful to evidence the presence of unperfused areas. A physical rehabilitation program subsequently allows to reduce the degree of functional impairment [Lewis, 1985;Moutet et al, 1991;Jebson et al, 1993].…”

High-pressure injection injury of the hand: an often underestimated trauma: case report with study of the literature

“…In the literature it varies from 40 to 800 bar [10,16]. A pressure of 7 bar is already sufficient to penetrate the skin.…”

Latex Paint-gun Injuries of the Hand: Are the Outcomes Better?

“…In an overview of injection injuries, Hogan and Ruland noted that there were 345 published cases of high-pressure injection injuries in the upper extremity [9]. Of these, 169 were caused by a paint-gun; paint was the injected material in 140 cases and paint thinner was injected in the remaining 29 [4,7,14,15,20,24,28,29,30,31,32]. Although paint-gun injuries have been reported, they are infrequent.…”