Finger compartment syndrome due to a high-pressure washer injury: A case report

BACKGROUND Although the finger compartment syndrome is not common, it compresses the neurovascular bundles in a limited space and blocks blood flow to the fingers, causing necrosis of the fingertips. Finger fasciotomy through unilateral or bilateral midline release of the finger can achieve decompression of the finger compartment. Herein, we report a case of the compartment syndrome in a finger injury caused by a high-pressure water flow which is commonly used in car washing stations. CASE SUMMARY A 60-year-old man injured his right middle finger while using a high-pressure washer at a car washing station. The patient complained of severe pain in his middle finger and a 0.2 cm punctured open wound on the volar side of the distal phalangeal joint of the middle finger. The fingertip was pale, numb, and characterized by severe swelling and a limited range of motion. Finger radiography showed that there was no fracture in the finger. Digital decompression was performed through finger fasciotomy by bilateral midline incision. On the second day after surgery, the color of the fingertip returned to pink, swelling was resolved, and the range of motion returned to normal. The sensation of the fingertip was completely restored, and the capillary refill test and pinprick test were positive. CONCLUSION The fingertip compartment syndrome can be caused by a high-pressure water flow damage to the fingers when using high- pressure washers at a car washing station. To avoid finger necrosis, rapid diagnosis of the finger compartment syndrome and appropriate digital decompression are essential to better outcome.