Injection injuries: seemingly minor injuries with major consequences

Background: High-pressure injection injuries are rare injuries, characterized by a small puncture wound that is often underestimated by physicians and patients. The injected substance leads to extensive tissue damage and sometimes to loss of the limb. Aim: To underline the severity of these injuries and to alert physicians to recognize them and treat them appropriately. Methods: Eight patients with injection injuries from lubricants (6) or solvents (2) were treated in a University Orthopaedic Department in a 5-year period. In all patients the mild initial symptoms were aggravated over the next 4-6 hours leading to a severe compartment syndrome of the hand. Five patients were referred with a mean delay of 3.8 days and 3 were treated immediately; all with debridement and compartment release. Results: The total number of procedures per patient was 2 to 5. In 3 patients a heterodigital flap was necessary whereas in one the second ray was amputated. Results were excellent in 5 cases and good in 3. Conclusions: In injection injuries, prompt diagnosis and immediate aggressive Surgical intervention are necessary to save the patients' digit/limb. Patients Should be informed about the severity of their injury, its potential complications and the multiple surgical procedures that may be required for a satisfactory functional result.