Dissemination pathways in high-pressure injection injuries of the hand: an experimental animal model

Objectives: High-pressure injection injuries of the hand may compromise the function of the hand or even result in amputations. Based on our clinical observations, we aimed to demonstrate neurovascular dissemination in an animal model. Methods: Ten adult New Zealand rabbits with a mean weight of 200 g were used. Under xylazine-ketamine anesthesia and using a triple connection system, the rabbits were injected one milliliter of black Indian ink in the third finger tip of the upper limbs at 4 atmos¬pheric pressure. The rabbits were sacrificed via intrac- ardiac injections for transhumeral amputation of all the upper limbs. All amputations were fixed in 10% forma¬lin, decalcified, and specimens obtained from fingers and distal and proximal regions of the wrist were stained with hematoxylin and eosin for histopathologic examination. Results: Transverse sections of the third finger showed subcutaneous deposition of Indian ink particularly in the pulp in all the specimens. In addition, all specimens from the distal wrist showed penetration into fascia, ten¬don sheaths, and neurovascular bundles of the third fin- g e r. Conclusion: Our results suggest that, in addition to the tissues mentioned in the literature, neurovascular bundles are primarily and seriously affected by high-pressure injection injuries of the hand.