Handcuff neuropathy: two unusual cases

Abstract

Handcuff applications may result in compression of peripheral nerves at the wrist, and most reported cases involve only the superficial radial nerve. In this report, two cases of bilateral handcuff neuropathy involving multiple nerves were confirmed by electrodiagnostic findings of membrane instability, prolonged latencies and/or conduction block. In addition to the superficial radial nerves, one case involved the median nerves, and a second case the ulnar nerves. It was postulated that injury might occur to any nerve at the wrist as a result of pressure and edema from handcuffs, with the radial nerve most frequently involved due to its superficial location. Radial nerve injury has been described as functionally insignificant; however for the two cases presented, in which the median or ulnar nerves were involved, significant disability resulted, and a rehabilitation program was indicated.