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Nowadays there is no surgical repair technique that can ensure recovery of tactile discrimination in the hand of an adult patient following nerve repair while very young individuals usually regain a complete recovery of functional sensibility. Post\u2010traumatic nerve regeneration is a complex biological process where the outcome depends on multiple biological and environmental factors such as survival of nerve cells, axonal regeneration rate, extent of axonal misdirection, type of injury, type of nerve, level of the lesion, age of the patient and compliance to training. A major problem is the cortical functional reorganization of hand representation which occurs as a result of axonal misdirection. Although protective sensibility usually occurs following nerve repair, tactile discriminative functions seldom recover \u2013 a direct result of cortical remapping. Sensory re\u2010education programmes are routinely applied to facilitate understanding of the new sensory patterns provided by the hand. New trends in hand rehabilitation focus on modulation of central nervous processes rather than peripheral factors. Principles are being evolved to maintain the cortical hand representation by using the brain capacity for visuo\u2010tactile and audio\u2010tactile interaction for the initial phase following nerve injury and repair (phase 1). After the start of the re\u2010innervation of the hand (phase 2), selective de\u2010afferentation, such as cutaneous anaesthesia of the forearm of the injured hand, allows expansion of the nerve\u2010injured cortical hand representation, thereby enhancing the effects of sensory relearning. Recent data support the view that training protocols specifically addressing the relearning process substantially increase the possibilities for improved functional outcome after nerve repair.<\/jats:p>","DOI":"10.1111\/j.1748-1716.2006.01653.x","type":"journal-article","created":{"date-parts":[[2007,1,23]],"date-time":"2007-01-23T04:28:45Z","timestamp":1169526525000},"page":"207-217","source":"Crossref","is-referenced-by-count":210,"title":["Hand function after nerve 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