Following a median nerve injury (1-11 years after injury) there may be an initial increase in the volume of the cortical representation, which subsequently declines during the restoration phase. These dynamic changes may involve both median and ulnar nerve cortical representation, because both showed negative correlation with time after injury. These findings are in agreement with animal studies showing that cortical plasticity is an important mechanism for functional recovery after peripheral nerve injury and repair.

In 2016, our primary modality for radiological examination of wrist trauma, was changed from radiography to cone-beam computed tomography (CBCT). This is a retrospective survey of carpal bone fractures detected by CBCT during 6 months in 2016/2017, compared with those found on conventional radiographs during 6 months in 2013/2014. The incidence of carpal fractures was three times higher during the CBCT period (92/100,000 per year) compared with the radiography period (29/100,000 per year) and the spectrum of anatomical locations was different between the two periods, with fractures of the lunate ( n = 6), trapezium ( n = 9), trapezoid ( n = 4) and capitate ( n = 1) detected by CBCT, in contrast to no fractures of these bones diagnosed during the 6 months radiography period. We suggest a more liberal use of CBCT for examination of wrist trauma considering the benefits of being able to give patients a correct primary diagnosis, treatment and prognosis. Level of evidence: III

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