Injections in hand surgery

Introduction Injection is an essential procedure in medicine, let alone in hand surgery. It entails the insertion of a sharp pointed hollow needle into the body for 2 reasons. Firstly, to retrieve tissue samples from the body and secondly, for the delivery of substances into the body. Injection is thus meant for either diagnostic, therapeutic or both purposes. Injection provides the hand surgeon with an added option in his/her armamentarium in the management of patient’s condition. It is thus important for the surgeon to be well versed in this procedure that has been proven to be beneficial. A thorough knowledge of the human anatomy and techniques of injection are the important prerequisites in order to achieve success in the use of this tool. Although it is a minimally invasive procedure, it is not totally safe or innocuous. It has the potential to cause noxious experience for the patient either physically or psychologically. Sometimes the traumatic experience may leave the patient scarred for life and they often develop trypanophobia (fear of injections) and needle phobia subsequently. Before the advent of proper imaging modalities, the procedure is virtually done blind and hence there is always a risk of potentially damaging structures within the body through trauma during needle insertion. In the current setting where quality imaging with more modalities and options available, injections nowadays can be done under quality imaging guidance thus minimizing or even eliminating the risk of collateral damage within the body. In addition, injections can now be done to regions of the body that are deeper and less accessible compared to the days when injections were done blind. Appropriate tissues can be obtained, accurate and optimal delivery of therapeutic substances can be achieved leading to better outcomes for the patients.