Postoperative wristwatch-induced compressive neuropathy of the hand: a case report.

Abstract

Introduction Postoperative peripheral nerve injuries are well-recognized complications of both surgery and anaesthesia and a leading cause of litigation claims. We present a rare cause of compressive sensory and motor neuropraxia of the median, ulnar and radial nerves of the right hand resulting from a wristwatch that was worn on the first postoperative night following minor surgery. Mechanisms of this compressive neuropathy are discussed, with specific recommendations made regarding the wearing of wristwatches, jewellery and constrictive clothing in the immediate postoperative period. • Case presentation A 12-year-old male Caucasian child presented with a complete glove a stocking sensory and motor neuropathy involving the right hand from a wristwatch that was worn on the first postoperative night following uneventful surgery for a minor procedure. Over the following 12 hours the oedema and erythema resolved with complete return of motor function. After 18 hours, the sensory deficit completely resolved. • Conclusion Postoperative neuropraxia is often preventable. Paediatric patients, especially if thin, may be particularly susceptible to a compression neuropathy from constrictive clothing or jewellery, in particular circumferential varieties such as wristwatches. These items should not be worn in the immediately postoperative period as pressure on peripheral nerves can result severe and debilitating nerve injury. Education should be given to all medical staff, carers or parents of children undergoing surgery to avoid wearing wristwatches, jewellery or constrictive clothing in the immediate postoperative period. Early medical evaluation of any postoperative nerve injury is of paramount importance.