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.
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