High-pressure injection injuries to the hand.

Analysis of 14 cases of high-pressure injection injury to the hand revealed that the mechanism of injury, the nature of the injected substance, the site of injection, delay in treatment, and treatment specifics all influence prognosis. Injuries from paint or spray guns appear to be the most devastating; injuries to digits are worse than those to the hand. Paint, thinners, and solvents cause great impairment. Delay in treatment likely compromises the outcome; steroids may be effective in some cases in reducing eventual impairment. Early recognition of the gravity of these wounds is important and early decompression, tetanus prophylaxis, antibiotics, and judicious steroid usage are advocated. Significant impairment results from many high-pressure injuries despite seemingly adequate treatment.