Rehabilitation of a Rare Combined Radial, Median, and Ulnar Nerve Injuries following Handcuff Compression: A Case Report
Published: June 1, 2026 | DOI: https://doi.org/10.7860/JCDR/2026/87867.23472
Abhishek Mandal, Manisha Mondal, Akanksha Saxena, Mandeep Kumar Jangra, Ruchika
1. Postgraduate Student, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India.
2. Consultant Physiotherapist, Department of Physiotherapy, Institute of Neurosciences, Kolkata, West Bengal, India.
3. Associate Professor, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India.
4. Associate Professor, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India.
5. Postgraduate Student, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India.
Correspondence
Dr. Akanksha Saxena,
Associate Professor, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala-133207, Haryana, India.
E-mail: akankshasaxena623@gmail.com
Prolonged compression and abnormal stretch is the cause of many types of Peripheral Nerve Injuries (PNI), but injury due to overtightened handcuffs is a rare occurrence. These neuropathies have a poor prognosis if not treated promptly. A 24-yearold man with combined radial, median, and ulnar nerve injury following handcuff restraint received a 40-day physiotherapy protocol intervention (30-40 min/session). Interventions included proprioceptive neuromuscular facilitation, functional electrical stimulation, and functional activities administered each day for 10 days and then five days/week for the remaining 30 days. Measurements were taken at baseline (T0), then at every 10 sessions (T1, T2, T3, T4). Progress was evaluated on a 10-session interval using the Quick Disabilities of the Arm, Shoulder and Hand (DASH), Patient Rated Wrist Evaluation (PRWE), pinch and hand grip strength using hand dynamometer. Grip and pinch strength improved from 0-10 kg and 0-5 kg, respectively whereas disability score on QuickDASH changed from 59.09% to 13.63% and PRWE improved from 48.5 to 4.5 point. An individually tailored advanced physiotherapy regime was effective in improving gross motor, fine motor skills and functional recovery of an individual with a rare handcuff injury. Significant improvements were also observed in elbow, wrist, and metacarpophalangeal joint range of motion. Thus, a structured, phase-wise physiotherapy approach can be the first line of effective treatment in functional recovery of individuals with a rare handcuff injury.
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