eMedicine Specialties > Orthopedic Surgery > Hand & Upper Extremity

High-Pressure Injection Injuries: Follow-up

Author: Jugpal S Arneja, MD, FRCSC, Assistant Professor, Division of Plastic Surgery, University of British Columbia; Attending Staff, Division of Plastic Surgery, British Columbia Children's Hospital
Coauthor(s): William Rennie, MD, Former Professor of Surgery, University of Manitoba; RB Turner, MD, FRCSC, Assistant Professor, Section of Plastic Surgery, University of Manitoba; W Reid Waters, MD, CM, FRCPSC, FACS, Associate Professor of Surgery, University of Manitoba; Former Head of Plastic Surgery Section, Winnipeg Regional Health Authority; Jonathan Toy, MD, Resident, Department of Surgery, Division of Plastic Surgery, University of Alberta Faculty of Medicine and Dentistry
Contributor Information and Disclosures

Updated: Jul 8, 2009

Outcome and Prognosis

High-pressure injection (HPI) injuries often manifest as innocuous lesions on the fingertip of a patient's nondominant hand. Depending on the substance involved, these injuries may follow a benign clinical course (for air and clean water) or may be deceptively destructive and lead to soft-tissue necrosis and amputation (for grease and paint). Proper triage and management of HPI injuries of the hand is imperative; the attending physician should recognize grease and paint injuries as surgical emergencies. A delay in treatment may result in inferior functional outcomes.17,40 In the digits, amputation rates are as high as 48%.3,17,22 Overall, HPI injuries result in significant impairment of function and reintegration into the work force, as well as aesthetic damage. The most common long-term impairments include cold intolerance and hypersensitivity; however, grip strength, pinch, range of motion, and 2-point discrimination are also affected.41,42,43

 


More on High-Pressure Injection Injuries

Overview: High-Pressure Injection Injuries
Workup: High-Pressure Injection Injuries
Treatment: High-Pressure Injection Injuries
Follow-up: High-Pressure Injection Injuries
Multimedia: High-Pressure Injection Injuries
References
Further Reading
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References

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Keywords

high-pressure injection injury, high-pressure injury, HPI injury, hand injury, finger injury

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Contributor Information and Disclosures

Author

Jugpal S Arneja, MD, FRCSC, Assistant Professor, Division of Plastic Surgery, University of British Columbia; Attending Staff, Division of Plastic Surgery, British Columbia Children's Hospital
Jugpal S Arneja, MD, FRCSC is a member of the following medical societies: American Academy of Pediatrics, American Burn Association, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Canadian Medical Association, Canadian Society of Plastic Surgeons, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Coauthor(s)

William Rennie, MD, Former Professor of Surgery, University of Manitoba
William Rennie, MD is a member of the following medical societies: Canadian Medical Association, Canadian Orthopaedic Association, and Quebec Medical Association
Disclosure: Nothing to disclose.

RB Turner, MD, FRCSC, Assistant Professor, Section of Plastic Surgery, University of Manitoba
RB Turner, MD, FRCSC is a member of the following medical societies: Canadian Medical Association, Canadian Medical Protective Association, and Canadian Society of Plastic Surgeons
Disclosure: Nothing to disclose.

W Reid Waters, MD, CM, FRCPSC, FACS, Associate Professor of Surgery, University of Manitoba; Former Head of Plastic Surgery Section, Winnipeg Regional Health Authority
W Reid Waters, MD, CM, FRCPSC, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American College of Surgeons, American Society of Plastic Surgeons, Canadian Medical Association, Canadian Society of Plastic Surgeons, International College of Surgeons, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Jonathan Toy, MD, Resident, Department of Surgery, Division of Plastic Surgery, University of Alberta Faculty of Medicine and Dentistry
Jonathan Toy, MD is a member of the following medical societies: Alberta Medical Association, American Society of Plastic Surgeons, Canadian Medical Association, and Canadian Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Peter M Murray, MD, Associate Professor of Orthopedic Surgery, Mayo Clinic College of Medicine; Director of Education, Mayo Foundation for Medical Education and Research, Jacksonville; Consultant, Department of Orthopedic Surgery, Mayo Clinic, Jacksonville; Consulting Staff, Nemours Children's Clinic and Wolfson's Children's Hospital
Peter M Murray, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for Hand Surgery, American Orthopaedic Association, American Society for Reconstructive Microsurgery, American Society for Surgery of the Hand, Florida Medical Association, Orthopaedic Research Society, and Society of Military Orthopaedic Surgeons
Disclosure: Small Bone Innovations Workshop Honoraria Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Thomas R Hunt III, MD, John D Sherrill Professor and Director of Orthopaedic Surgery, Surgeon in Chief of UAB Highlands Hospital, Director of Hand and Upper Extremity Fellowship, University of Alabama at Birmingham
Thomas R Hunt III, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for Hand Surgery, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, American Society for Surgery of the Hand, AO Foundation, Mid-America Orthopaedic Association, and Southern Orthopaedic Association
Disclosure: Tornier Consulting fee Review panel membership

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

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