High-pressure injection injuries are uncommon traumas characterized by a great discrepancy between a deceptively small entrance site and the extensive and underestimated subcutaneous tissue injury and destruction. Without early and correct treatment these lesions lead to disability and local extensive destruction. This paper presents a case of high-pressure injection injury to the metacarpal-phalangeal articulation of the finger from industrial paint; the extent of the injury was underestimated at presentation and improperly treated. This case required surgical staged management, with a total time of medical leave of three months.