High-pressure cement injection injury of the hand: a case report.

Abstract

Modern equipment allows injection of substances at much higher pressures than previously. We describe a high-pressure cement injection injury to the hand and how its management differs from other injection injuries. This injury was treated by the established standard for this surgical wound: immediate debridement. The wound had the same mechanism, pathology, bacteriology, and treatment as other similar wounds. Prognosis after high-pressure injection injuries, however, also depends on the substance injected. Treatment for cement injection injuries differs because of the unique properties of cement. Immediate intervention is necessary for decompression and minimization of chemical burn. Removing the final few fragments of cement after they have hardened may decrease the number of debridements and soft tissue destruction. Serial x-rays can be used to guide debridements, but if serial x-ray films are not obtained, a final x-ray is mandatory to ensure removal of all cement.