@article{ref1,
title="Forensic evaluation of alleged wrist restraint/handcuff injuries in survivors of torture utilizing the Istanbul Protocol",
journal="International journal of legal medicine",
year="2021",
author="Crosby, Sondra S. and Stein, Andrew B. and Kimball, Sarah and Neufeld, Miriam Y.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Despite being a common form of abuse, there is a paucity of literature describing shackling and wrist restraint injuries among survivors of torture. Forensic  evaluation of alleged wrist restraint/handcuff injuries in survivors of torture  presents challenges to the evaluator, especially if the injuries are remote and do  not leave lasting marks nor neurologic deficits. Thorough history-taking and  physical examination are critical to effective forensic documentation. Guidance is  provided in The Manual on Effective Investigation and Documentation of Torture and  Other Cruel, Inhuman or Degrading Treatment or Punishment (Istanbul Protocol), the  gold standard for the medicolegal documentation of torture. This guidance relies  primarily on physical findings, with less direction provided on how to interpret  historical evidence or when historical evidence provided by the patient can be  interpreted as highly consistent with alleged injury in the absence of current  physical findings. Through a case-based review, we present diagnostic strategies for  the evaluation of alleged abuse involving wrist restraints/handcuffs, focusing on  skin, neurologic, and osseous injuries. We highlight key findings from both the  history and physical examination that will allow the evaluator to improve the  accuracy of their expert medical opinion on the degree to which medical findings  correlate with the patient's allegations of wrist restraint injuries.<p /> <p>Language: en</p>",
language="en",
issn="0937-9827",
doi="10.1007/s00414-020-02451-5",
url="http://dx.doi.org/10.1007/s00414-020-02451-5"
}