title: Postoperative wristwatch-induced compressive neuropathy of the hand: a case report.
abstract: BACKGROUND
  Postoperative peripheral nerve injuries are well-recognised 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.
  
  
  METHODS
  A 12-year-old white boy presented with a complete glove and stocking sensory and motor neuropathy involving his 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.
  
  
  CONCLUSIONS
  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 immediate postoperative period as pressure on peripheral nerves can result in severe and debilitating nerve injury. Education should be given to all medical staff, carers or parents of children undergoing surgery on the avoidance of wearing wristwatches, jewellery or constrictive clothing in the immediate postoperative period. Early medical evaluation of any postoperative nerve injury is of paramount importance.
authors.affiliation: Department of Anaesthesia, Austin Hospital, Heidelberg, VIC, 3084, Australia. laurence.weinberg@austin.org.au.|Department of Surgery and Anaesthesia Perioperative Pain Unit, University of Melbourne, Heidelberg, 3084, VIC, Australia. laurence.weinberg@austin.org.au.
authors.forename: Laurence
authors.initials: L
authors.lastname: Weinberg
authors.affiliation: Department of Radiology, Box Hill Hospital, Box Hill, 3128, VIC, Australia. spanger@bigpond.net.au.
authors.forename: Manfred
authors.initials: M
authors.lastname: Spanger
authors.affiliation: Department of Anaesthesia, Austin Hospital, Heidelberg, VIC, 3084, Australia. drchongtan@gmail.com.
authors.forename: Chong
authors.initials: C
authors.lastname: Tan
authors.affiliation: Department of Surgery, Austin Hospital, Heidelberg, VIC, 3084, Australia. merhdad.nikfarjam@austin.org.au.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Nikfarjam
mesh_terms: D002648:Child; D006801:Humans; D055498:Jewelry / Q000009:adverse effects*; D008297:Male; D009408:Nerve Compression Syndromes / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D014953:Wrist / Q000294:innervation*