Hand reconstruction after a high-pressure injection injury: review of biophysics and prognostic classification

High-pressure injection injuries are rare but potentially devastating, often presenting with deceptively minor skin wounds that conceal extensive internal damage. This case highlights the Pressure, Anatomy, Content and Time of presentation classification system to standardise injury assessment and staged surgical management of an upper limb injury from a sealant gun: initial debridement and pedicled groin flap coverage, followed by extensor tendon reconstruction using a three-tailed fascia lata graft. Postoperative rehabilitation yielded full range of motion, restoration of grip strength from 25 kg to 42 kg and return to occupational function. Thus emphasising timely and decisive intervention allowing return of complete hand function from an extensive injury.