High-Pressure Injection Injuries to the Hand

Abstract

Background: High-pressure injections into the hand, burden devastating and permanent functional impairments. Many materials including paint, paint thinner, gasoline, oil and grease are reported as the causative agents. These injuries need multiple procedures and reconstructions most of the time and 40% of the injuries may end with amputation of the injured part. Objectives: The aim of this study was to report the treatment outcomes and methods of treatments of patients with high-pressure injection injuries of the hand. Methods: We retrospectively reviewed the medical records, imaging files and demographic data of patients, who were treated at our center due to the high-pressure injuries to their hands. We recorded the kind of the injected materials, time to the first treatment procedure, times of operation, and methods of their treatments. The outcomes of the injuries as well as the deficiency of the digital joints motion were also reported. Results: Nine cases with high-pressure injury of the hand were enrolled in this study. All patients were male with mean age of 26.88

High-Pressure Injection Injuries to the Hand: A Case Report

“…Depending on the volume and materials injected, the finger may be distended, swollen, and tender on palpation. If vessels in the involved digit have been thrombosed or compressed, the digit may be pale, anesthetic, or even ischemic [4]. In the case of an air injection injury, associated crepitus and subcutaneous emphysema are possible [7].…”

“…Subsequently, it has been reported that this may be due to not only gases but also a variety of liquids such as pressurized paint, grease, diesel fuel, helium, carbon dioxide and nitrous oxide [3]. The injected material has deleterious effects in several ways including a direct toxic effect of the involved chemical, ischemia, high-velocity mechanical impact, secondary infection, a significant rise of pressure in the closed palmar or digital space with consequ-ent compartment syndrome [4]. Despite the nontoxicity of injected air, the importance of acute surgical intervention must be emphasized, as there is a risk of high-pressure soft tissue damage.…”