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February 12, 2026BMJ Case Reports0 citations

Hand reconstruction after a high-pressure injection injury: review of biophysics and prognostic classification

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SDSuvashis DashRTRaja TiwariNTNandini Singh Tanwar

Key Points

  • The aim is to evaluate the management and prognosis of high-pressure injection injuries to the hand.
  • Utilized the Pressure, Anatomy, Content, and Time classification system for injury assessment.
  • Performed initial debridement followed by pedicled groin flap coverage.
  • Conducted extensor tendon reconstruction using a three-tailed fascia lata graft.
  • Implemented a postoperative rehabilitation program.
  • Achieved full range of motion post-rehabilitation.
  • Increased grip strength improved from 25 kg to 42 kg.
  • Facilitated return to occupational function.

Abstract

High-pressure injection injuries are rare but potentially devastating, often presenting with deceptively minor skin wounds that conceal extensive internal damage. This case highlights the Pressure, Anatomy, Content and Time of presentation classification system to standardise injury assessment and staged surgical management of an upper limb injury from a sealant gun: initial debridement and pedicled groin flap coverage, followed by extensor tendon reconstruction using a three-tailed fascia lata graft. Postoperative rehabilitation yielded full range of motion, restoration of grip strength from 25 kg to 42 kg and return to occupational function. Thus emphasising timely and decisive intervention allowing return of complete hand function from an extensive injury.

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Cite This Study

Dash et al. (2026) studied this question.

synapsesocial.com/papers/698d6d9f5be6419ac0d52b7fhttps://doi.org/10.1136/bcr-2025-270012
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