High-pressure injection injury: a hand-threatening emergency.

A variety of tools mounted with high-pressure nozzles cause a typical pattern of hand injuries. Often the relatively mild initial symptoms conceal the actual degree of tissue damage and the need for prompt treatment. As illustrated by a case of dye impression, early extensive surgical exploration and radical removal of the injected agent are mandatory to minimize sequelae and to avoid mutilating complications. Pathophysiology and surgical management of this hand-threatening emergency are outlined.