High-Pressure Injection Injury of the Hand—A Rare but True Surgical Emergency

Abstract

Background/Objectives: The aim is to bring attention to the existence of a rare type of trauma of the hand, high-pressure injection injury, that appears to be minor with negligible signs and symptoms within the first hours after the accident, but in reality, produces significant tissue destruction with severe consequences. Recognizing this type of trauma by medical personnel, understanding the mechanisms involved, and knowing the etiological and prognostic factors can lead to early treatment initiation and avoid severe mutilating sequelae. Methods: A retrospective study on 16 patients diagnosed with high-pressure injection injuries, including water, air, paint, paint mixed paint with thinner, petroleum jelly, and lime (washable paint containing calcium oxide). The patients’ epidemiological data, the time from accident to diagnosis, reasons for delayed diagnosis, treatments applied, and outcomes were recorded and evaluated. Results: All injuries occurred at the workplace due to negligence. Oil-based paint was implicated in 31.25% of cases. The most frequently affected anatomical region was the volar surface of the distal phalanx of the nondominant hand index finger. In one case, delayed presentation to medical care and diagnosis resulted in a compartment syndrome, requiring amputation. Conclusions: It is crucial to recognize and understand this type of trauma, as it constitutes an emergency due to its rapid progression. Delayed diagnosis can result in massive tissue destruction, potentially leading to the loss of limb segments and debilitating functional sequelae, which may severely impact a patient’s socio-professional life.