[High pressure injection injuries to the hand].

The severity of high pressure injection injuries to the hand is often underestimated in the initial clinical examination. Therefore, it is critical to obtain information about the course of the accident, the pressure involved and the injected substance. X-ray examination can reveal the injected substance or accompanying air in the tissues and therapy is usually surgical. All compartments should be released and all foreign material should be thoroughly removed. There is often a need for second look surgery. Wound closure should be achieved within 1 week and the decision about amputation should fall within 2 weeks. Hand therapy is essential beginning from the day after trauma and it may be continued for weeks or even months.From 1998 to 2008, 36 patients were treated after high pressure injection injury to the hand, 19 patients were transferred to the replantation centre immediately and 17 secondarily. These 19 injuries resulted in finger amputations and/or pain syndromes in 12 patients (33%) including 2 out of the primary group (10%) and 10 out of the secondary group (59%). It can be concluded that high pressure injuries to the hand should be treated in replantation centres.