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Updated: May 25, 2025

Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
Acute Carpal Tunnel Syndrome Secondary to Handcuffs Necessitating Emergency Orthopedic Consultation and Operative
Fabian Jano1,2, Kelly MacKenzie1,2, Vivek K Bilolikar2,3
1Department of Emergency Medicine, Emergency Medicine Residency Program, Jefferson Einstein Philadelphia Medical Center, Philadelphia, Pennsylvania, USA.
Abstract:
We present a case of acute carpal tunnel syndrome secondary to tight handcuffs in a detained patient. The severity of the motor and sensory deficits prompted consultation with orthopedic specialists and admission for an observation period with ultimate emergency operative intervention. Handcuff neuropathies are well documented in the literature, mainly involving the superficial branch of the radial nerve, which has strict sensory input into the dorsum of the hand. Less common median nerve neuropathies have also been documented following handcuff injury; however, none have required emergency intervention. We aim to highlight this unusual presentation and the emergency nature of the condition, as well as advocate for increased caution when caring for detained patients in the emergency department.
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