HIGH PRESSURE INJECTION INJURY

Question 1

Mechanism

Answer 1

Injection of substance under high pressure (>2000 psi)

Intense inflammatory response -> Ischemia

Question 2

Imaging

Answer 2

Plain radiographs of hand and forearm
Can delineate the extent of the injection

Question 3

Management

Answer 3

Orthopedic Emergency
Immobilize and elevate hand
Administer tetanus ppx
Broad Spectrum antibiotics
Immediate ortho / plastics consultation for early
surgical debridement and decompression