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Injection of high-pressure hydraulic oil into the hand or forearm nearly always requires emergency surgery to stop the damage.   Oil-injection-injuries of the hand are not common, but occur with enough frequency - and the consequences of mismanaging them are so serious—that victims, supervisors, emergency medical personnel, and primary care physicians must be able to diagnose them.   The outcome of the injury is dependent on the type, amount and velocity of the material injected; site of injection; and the prompt and appropriate management of the injury.  

Technicians working in equipment shops or from field-service trucks are at risk for high-pressure-injection injuries from more sources than mobile hydraulic systems.   For instance, common-rail fuel systems in today’s machines operate at pressures exceeding 30,000 psi, and high-pressure paint guns and pressure washers with detergents are routinely used for equipment maintenance.  

Injection can occur at pressures as low as 100 psi.   It’s all about how and where the injury is sustained.   And there currently is no hand protection available to prevent an oil-injection injury—that is, nothing you could wear and still be able to work.”   The damage caused by hydraulic oil or other toxic fluids injected into a hand or forearm results from several sources.  The first is simply the force of the injectate (the material injected).  

The process of injecting at high pressure will damage tissue on the way in.   It’s almost like being shot with a gun.   There’s a path the injectate follows and soft tissue will be damaged along the way.  Damage of a more insidious nature results from two primary sources: the chemical composition of the injectate and the subsequent pressure the injectate causes when it enters one or more of the many “compartments” in the hand or arm.  

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