Handcuff neuropathy revisited

Peripheral nerve injury due to handcuff placement has been reported in the past, always involving the superficial radial nerve, and sometimes involving other peripheral nerves at the wrist. We present two unusual cases in which the ulnar nerves were affected, but the radial nerves were normal or only minimally affected. This serves to emphasize a broader clinical spectrum of handcuff injury. Significant disability may result. These cases also involve alcohol intoxication, which may predispose patients to this type of injury because of overly aggressive application of restraints motivated by the patients' bellicose behavior.