High-pressure injection injury with concrete to the hand and forearm

Abstract

High-pressure injection injuries to the upper extremities are uncommon yet serious, particularly when they involve substances such as concrete. These injuries, frequently occurring in industrial environments, can lead to substantial tissue damage and functional impairment. A 24-year-old male patient who incurred a high-pressure concrete injection injury to his left hand and forearm while employed at a construction site was admitted. The injury, originally seeming minor, involved concrete penetration into the thenar region and extended through the forearm, resulting in significant damage to muscles, tendons, and nerves. The immediate medical care comprised immersion of the injured arm in warm water, administration of intravenous antibiotics, and tetanus prophylaxis, succeeded by rapid debridement in the operating room. Through a series of surgeries, comprising sequential debridements and reconstructive interventions, hand function of the patient was acceptable regarding the occupational return. Radiographic imaging was essential in evaluating the severity of injury and informing surgical choices. Preoperative radiological clarification of the extension of the upper extremity to the anatomical regions with high pressure is of utmost importance in determining the location and size of the surgical incision to remove the vital initial debridement and cement from the anatomical regions as much as possible. This case highlights the significance of prompt identification, assertive treatment, and sequential surgical procedures in high-pressure injection injuries. The necessity for proactive workplace safety protocols and heightened awareness of the potential severity of these injuries is underscored. We believe that this case report enhances the comprehension of the difficulties and problems associated with treating high-pressure concrete injection injuries to the upper extremities.

Citation: Sariaslan AY, Sekerci OT, Unlu OC, Arat F, Gurbuz K. Highpressure injection injury with concrete to the hand and forearm. Jt Dis Relat Surg 2026;37(1):282-287. doi: 10.52312/jdrs.2026.2316.