Outcome Following Peripheral Nerve Injury of the Forearm

Loss of hand function can be a frightening experience, the hand is an integral part of what makes us human. Nowhere else in the body is there such an amazing and complex functioning of bones, joints, muscles, tendons, nerves, blood vessels and skin as in the hand. The proper function and balance of all these elements is required for the hand to function to its full potential. The hands are the primary tool for interacting with our environment and, through touch, are also crucial for receiving information about our surroundings. About a quarter of the motor cortex in the human brain (the part of the brain which controls all movement in the body) is devoted to the muscles of the hands. This is usually illustrated with a drawing of a human figure draped over the side of the brain, body parts sized proportional to the amount of brain devoted to their movement, referred to as a homunculus - as illustrated in this drawing from Dr. Wilder Penfield’s monograph “The Cerebral Cortex of Man”. Until illness or injury forces people to focus on the importance of their hands, few people ever consider the consequences of being unable to use them. Any loss of hand function can have serious economic and psychological consequences. In fact, losing the use of your hand often means losing your job. Our hands are also part of our identity. Patients with severe upper extremity injuries can suffer psychologically from post-traumatic stress disorder. Unfortunately, we often fail to appreciate the function of the upper limb until it is injured, and that happens quite often.