High-pressure injection injury to the hand is rare and is frequently underestimated; therefore, improper treatment can result in permanent functional loss or amputation. We report a case of high-pressure injection injury of the middle finger in a 56-year-old man sustained while painting the bottom of a ship. At 27 hours after injury, we performed sufficient debridement by emergency surgical operation, and pain and swelling of the injured finger improved. However, skin necrosis of the affected finger resulted from insufficient circulation. The finger was reconstructed using a free radial forearm flap at 19 days after initial surgery. One year after injury, the patient returned to work and had a pain-free hand with almost normal function. Prompt surgical intervention can improve the outcomes of high-pressure injection injury of the hand.
