title: The optimization of peripheral nerve recovery using cortical reorganization techniques: A retrospective study of wrist level nerve repairs.
abstract: METHODS
  Retrospective case series.
  
  
  BACKGROUND
  Outcomes following peripheral nerve repairs have not significantly improved over the past few decades. A new protocol using cortical reorganization techniques was developed with the goal of improving nerve recovery in the hand.
  
  
  OBJECTIVE
  To determine if early sensory re-education using cortical reorganization techniques improved sensory outcomes in the hand after repair of wrist-level nerve injuries.
  
  
  METHODS
  A retrospective study was completed of wrist-level peripheral nerve repairs in patients who underwent a sensory re-education protocol which included cutaneous anesthesia, tactile stimulation, and sensory and motor imagery. Data for static 2-point discrimination, Semmes Weinstein monofilament assessments and the shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores were collected.
  
  
  RESULTS
  At four months post-repair, three of seven of the median nerve lacerations had static 2-point discrimination of 7 mm or less in at least one digit. Using the Semmes Weinstein monofilaments, 9 of 11 nerve repairs felt the 4.31 filament (protective) or better by eleven months with five able to perceive the 2.83 filament (normal) in that time frame.
  
  
  CONCLUSIONS
  This limited retrospective study suggests that early sensory re-education using cortical reorganization techniques may improve sensory outcomes. A larger scale study is indicated to confirm our findings.
  
  
  METHODS
  IV.
authors.affiliation: Plastic and Hand Surgery, Regions Hospital, St. Paul, MN, USA. Electronic address: bwalbruch@gmail.com.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Walbruch
authors.affiliation: Plastic and Hand Surgery, Regions Hospital, St. Paul, MN, USA.
authors.forename: Loree
authors.initials: L
authors.lastname: Kalliainen
mesh_terms: D000328:Adult; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery*; D002540:Cerebral Cortex / Q000503:physiopathology*; D005260:Female; D006225:Hand / Q000294:innervation*; D006801:Humans; D007092:Imagination / Q000502:physiology; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000534:rehabilitation*; D014110:Touch / Q000502:physiology; D055815:Young Adult
keywords: Cortical reorganization; Peripheral nerve; Sensory re-education; nerve repair