# Acute Carpal Tunnel Syndrome Secondary to Handcuffs Necessitating Emergency Orthopedic Consultation and Operative Intervention

## TL;DR

A patient developed severe carpal tunnel syndrome from tight handcuffs, requiring emergency surgery and highlighting risks in detained patients.

## Contribution

This case highlights an unusual and urgent instance of handcuff-induced carpal tunnel syndrome requiring emergency surgery.

## Key findings

- Acute carpal tunnel syndrome from handcuffs led to severe motor and sensory deficits.
- Emergency operative intervention was necessary after orthopedic consultation.
- This case emphasizes the need for caution when handling detained patients in emergency settings.

## 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.