Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2023; 11(13): 3017-3021
Published online May 6, 2023. doi: 10.12998/wjcc.v11.i13.3017
Finger compartment syndrome due to a high-pressure washer injury: A case report
Jun Ho Choi, Seung Yeon Choi, Jae Ha Hwang, Kwang Seog Kim, Sam Yong Lee
Jun Ho Choi, Seung Yeon Choi, Jae Ha Hwang, Kwang Seog Kim, Sam Yong Lee, Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital Chonnam National University Medical School, Gwangju 61469, South Korea
Author contributions: Choi JH and Choi SY contributed to manuscript writing and data collection; Hwang JH and Kim KS contributed to editing and conceptualization; Lee SY contributed to supervision; All authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jae Ha Hwang, MD, PhD, Professor, Surgeon, Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, South Korea. psjhhwang@daum.net
Received: November 9, 2022
Peer-review started: November 9, 2022
First decision: January 30, 2023
Revised: February 3, 2023
Accepted: April 4, 2023
Article in press: April 4, 2023
Published online: May 6, 2023
Processing time: 166 Days and 23.4 Hours
Abstract
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.

Keywords: Compartment syndrome; Crush injuries; Fasciotomy; Finger injuries; Case report

Core Tip: Though the fingertip compartment syndrome is not common, the digital decompression through finger fasciotomy with midlateral release is essential. In this case, compartment syndrome occurred in the middle finger without fracture due to a crushing injury caused by a common high-pressure washer. Fasciotomy was performed immediately. The patient was concerned about necrosis of the finger and demanded early amputation on the first day after operation. But the complete recovery was confirmed on the next day without significant complications. Therefore, we should avoid determining the recovery of finger circulation hastily and performing premature amputation of the fingertip.