Complaints of pain after use of handcuffs should not be dismissed

EDITOR—Handcuffs are commonly used to restrain prisoners. It is not unusual for them to be applied in violent circumstances and for the prisoner to struggle. This can lead to overtightening of the handcuffs and considerable trauma to the structures around the wrist. We have recently seen fractures, lacerations, and injuries to the radial, ulnar, and median nerves (table). This is probably the tip of the iceberg, as many people with such injuries fail to attend for assessment, follow up, or investigation.