High-pressure injection injuries to the hand.

The severity of high-pressure injection injuries to the hand is often underappreciated on initial presentation. These injuries require urgent and thorough surgical débridement. Despite the advances in our understanding of this injury type and the decline in amputation rates, the risk of long-term morbidity with diminished function and chronic symptoms remains high, and the role of systemic steroids in treatment is uncertain. Functional outcome of the hand and upper extremity following high-pressure injection injuries depends on a number of factors, including the magnitude of the initial wounding force, the chemical properties and volume of the substance injected, the presence of secondary infection, and the timing and thoroughness of débridement. Further investigation is required to determine the relative significance of these factors and the effectiveness of steroids in treatment.