Injection injuries: seemingly minor injuries with major consequences

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.

To underline the severity of these injuries and to alert physicians to recognize them and treat them appropriately.

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.

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.

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.