BACKGROUND: Although median nerve neuropathy and carpal tunnel syndrome (CTS) 
are known complications of both untreated and acutely treated distal radius 
fracture, median neuropathy after correction of distal radius malunion is not 
commonly reported in hand surgery literature. We describe a patient with severe 
CTS after corrective osteotomy, open reduction internal fixation (ORIF) with a 
volar locking plate (VLP), and bone grafting for distal radius malunion.
METHODS: We report a case of severe acute CTS as a complication of corrective 
osteotomy with bone grafting for distal radius malunion.
RESULTS: The patient was treated with surgical exploration of the median nerve 
and carpal tunnel release.
CONCLUSION: The authors report a case of acute CTS after ORIF with VLP for a 
distal radius malunion warranting surgical exploration and carpal tunnel 
release. Treatment teams must be aware of this potential complication so that 
the threshold for reoperation is low and irreversible damage to the median nerve 
is prevented.