Brain plasticity and hand surgery: An overview

The hand is an extension of the brain, and the hand is projected and repres ented in large areas of the motor and sensory cortex. The brain is a compli cated neural network which continuously remodels itself as a result of chan ges in sensory input. Such synaptic reorganizational changes may be activit y-dependent, based on alterations in hand activity and tactile experience, or a result of deafferentiation such as nerve injury or amputation. Inferio r recovery of functional sensibility following nerve repair, as well as pha ntom experiences in virtual, amputated limbs are phenomena reflecting profo und cortical reorganizational changes. Surgical procedures on the hand are always accompanied by synaptic reorganizational changes in the brain cortex , and the outcome from many hand surgical procedures is to a large extent d ependent on brain plasticity.