Ischemic monomelic neuropathy is a well known entity following compression, casts or tourniquet use predominantly in upper limbs. One of the devastating forms is increasingly reported after tying hands of suspects/accused persons with plastic zip handcuffs by security agencies. This is especially increasing in number in countries who are war torn or coping with terrorism after 9/11.

 We report a case of a 22 years old male who was arrested by security agency as a suspect. His hands were tied with plastic zip handcuffs from behind for 36 hours continuously. Patient developed numbness in few minutes followed by weakness his upper limbs within 2 hours. 36 hours after cutting the zip tie he was unable to flex forearms and move his hands muscles properly. Examination revealed normal bulk and tone while there was decrease pin prick in distal forearm and hands. Finger flexion and abduction had power 2/5 while forearm flexion was 3/5 and extension 4/5.

Plastic zip type handcuffs produces rapid and severe IMN as compared to other means of handcuffs. This can lead to devastating axonal loss in hours and result in long lasting handicap condition for the patients. There is dire need to strongly discourage and or discontinue this type of tie by security agencies.