High-pressure injection injury: Difference between revisions

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**May show extent of injection of radiopaque substances
**May show extent of injection of radiopaque substances


==Treatment==
==Management==
*Splint and Elevate
*Splint and Elevate
*Emergent ortho/hand surgeon consult
*Emergent ortho/hand surgeon consult
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**Digital blocks are contraindicated
**Digital blocks are contraindicated


==Source==
==See Also==
Tintinalli's
*[[Hand and finger fractures]]
 
==References==
<references/>


[[Category:Ortho]]
[[Category:Ortho]]

Revision as of 14:22, 2 December 2015

Background

  • Surgical emergency
    • Amputation rates are as high as 30%
  • Occurs with grease, paint, and fuel guns; usually injected into non-dominant hand
  • Most important factor is type of injected material
    • Paint produces large, early inflammatory response w/ high rate of amputation
    • Grease causes small inflammatory response w/ lower rate of amputation

Diagnosis

  • Benign appearance of small injection site in immediate post-injection period is misleading
    • With time digit becomes edematous, pale, and severely tender to palpation
  • X-ray
    • May show extent of injection of radiopaque substances

Management

  • Splint and Elevate
  • Emergent ortho/hand surgeon consult
    • Admission
  • Early surgical decompression and debridement
    • >10hours to OR with increased amp rates
  • Tetanus
  • Abx
  • Analgesia
    • Digital blocks are contraindicated

See Also

References