High-pressure injection injury of the hand

Abstract

Hand injuries due to injection of substances by high-pressure industrial devices is a pathology which the family doctor may have to face. These are rare lesions (0.025-0.25% of the hand injuries) that mostly affect the first finger of the non-dominant hand. Apparently benign but with high risk of substantial long-term morbidity, undervalued many times. Mistakes in the initial management of these injuries can cause serious functional sequelae and amputations. The aim of this article is to review and summarize the main concepts of etiopathogenesis, diagnosis, treatment and prognosis of these lesions, as well as the lines of action in their prevention, in order to raise awareness among health personnel for the need to administer a quick and aggressive treatment in the first hours, to avoid complications and consequences so important that they can reach 48% of finger amputations. (Medical action need be standardized). Since the three main prognostic factors are the characteristics of the injected substance (type, amount, pressure and temperature), the anatomical area damaged and the time elapsed between the accident and the start of treatment, it is evident that early treatment determines the result. It is the only factor that the physician can change. Prevention is probably the issue to address to achieve the challenge of reducing the final consequences as much as possible.