Cortical plasticity following upper extremity injury and reconstruction.

Today's view of the adult central nervous system is that of an adaptive and responsive system. Plastic surgeons, because of the motor and sensory reconstructions they perform, need to have an understanding of brain plasticity following upper extremity injury, reconstruction, and rehabilitation. Functional MRI and transcranial magnetic stimulation can identify cortical plasticity in humans. For instance, these techniques have identified changes in excitability and body site representation in the motor cortex in patients following motor reconstruction and motor relearning. Therefore, cortical plasticity and its manipulation may be an important contributor to functional outcome following reconstruction. In the future, cortical plasticity may have implications for reconstruction and rehabilitation.