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

Sep 30, 2026

Uploaded by dawugda

High-pressure injection injuries to the upper extremities are uncommon yet serious, especially when concrete is involved. The case describes a 24-year-old man who sustained a high-pressure concrete injection into his left hand and forearm at a construction site, initially appearing minor but penetrating the thenar region and extending through the forearm. Concrete penetration caused extensive muscle, tendon, and nerve damage, treated with warm-water immersion, intravenous antibiotics, tetanus prophylaxis, early debridement, and sequential reconstructive surgeries guided by radiographic imaging.

LanguageEnglish

CategoryHealthcare

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Pages6

Reading Time15 min

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Case report

Abstract

Keywords

Case description and imaging

Discussion of mechanisms and evaluation

Joint Diseases and Related Surgery Jt Dis Relat Surg 2026;37(1):282-287 CASE REPORT High-pressure injection injury with concrete to the hand and forearm Ahmet Y. Sariaslan, MD1􀀬 , Omer T. Sekerci, MD1􀀬 , Omer Can Unlu, MD2􀀬 , Feridun Arat, MD2,3􀀬 , Kaan Gurbuz, MD1,4􀀬 1Department of Orthopedics and Traumatology, Health Science University, Kayseri Medical Faculty, Kayseri, Türkiye 2Department of Orthopedics and Traumatology, Kayseri City Hospital, Kayseri, Türkiye 3 Department of Orthopedics and Traumatology, Erciyes University Faculty of Medicine, Kayseri, Türkiye 4 Department of Orthopedics and Traumatology, Kızılay Hospital, Kayseri, Türkiye Hand injuries are common in daily emergency surgery routine and are mostly caused by work accidents.[1,2] High-pressure injection injuries to the hand are uncommon, and those to the forearm with concrete have been documented only once; yet, they are regarded as a serious clinical entity and typically considered a surgical emergency.[3] Since its initial description in 1925 in German and 1937 in English, the incidence of these injuries has progressively escalated alongside the rising prevalence of high-pressure industrial machinery.[4,5] A pressure of 100 psi can penetrate the skin, whereas high-pressure industrial machinery operates at pressures ranging from 2,000 to 20,000 psi, potentially inflicting significant harm even without direct contact with the skin or upper extremity protective gear. The severity of those injuries | Received: April 06, 2025
Accepted: September 18, 2025
Published online: November 07, 2025
Correspondence: Kaan Gurbuz, MD. Kızılay Hastanesi, Ortopedive Travmatoloji Kliniği, 38230 Melikgazi, Kayseri, Türkiye.
E-mail: [drkagangurbuz@gmail.com](drkagangurbuz@gmail.com)
[Doi:](Doi: 10.52312/jdrs.2026.2316)[ 10.52312/jdrs.2026.2316](Doi: 10.52312/jdrs.2026.2316) | | --- | | 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 . | | ©2026 All right reserved by the Turkish Joint Diseases Foundation | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes ([http://creativecommons.org/licenses/by-nc/4.0/](http://creativecommons.org/licenses/by-nc/4.0/)). 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 signif

FAQs

What makes high-pressure concrete injection injuries particularly serious?

They are uncommon but can cause profound tissue damage and functional impairment because high pressure can drive the material deep into the hand and forearm beyond what the initial wound size suggests.

How was the patient initially managed after the concrete injection injury?

Immediate care included warm-water immersion of the injured arm, intravenous antibiotics, and tetanus prophylaxis, followed by rapid debridement in the operating room.

Why was radiographic imaging emphasized in this case?

Imaging was essential to determine the extent of injected concrete throughout anatomical regions, which guided surgical incision planning and the removal of cement and initial necrotic tissue.

Sep 30, 2026

Uploaded by dawugda