P17-S Repeated compression radial neuropathies caused by rope bondage

Abstract

Rope bondage or shibari represents voluntary binding of a person with a rope and can lead to compression injury to peripheral nerves. We present a case of the radial nerve injury in suspension. A 29-year-old woman with a BMI of 17.5 was tied up with a 6-mm jute rope and suspended by the upper limbs, torso and hips for 25 min. The rope was placed in the middle third of the brachium. On removing the rope, she had a left wrist and a finger drop with decreased posterolateral hand sensation. Radial nerve conduction studies was performed on day 48. Compound muscle action potential was recorded from extensor digitorum communis. Conduction velocity was reduced to 19 m/s in the spiral groove segment, conduction block was 95.3%. Sensory conduction studies were normal. Clinical improvement began after 3 months with complete improvement after 5 months. Seventeen months after the recovery, this patient re-compressed both radial nerves after a similar suspension lasting about 8 min. The improvement began after one week and completed after 4 weeks. The third compression episode, that occurred three years after the first compression, lasted five minutes with clinical recovery in two minutes later. Nerve conduction studies demonstrated normal motor and sensory conduction velocities in radial, median, ulnar, peroneal, tibial and sural nerves. A high-resolution ultrasound examination showed a slight increase in the cross-sectional area of the left radial nerve in the spiral groove compared to the opposite side. Conclusion Rope bondage often causes injury to the radial nerve.