Traumatic peripheral nerve injuries of the upper limb remain a significant cause of long-term disability, chronic pain, and impaired quality of life, particularly among young and active individuals. While timely surgical repair restores structural continuity, functional recovery ultimately depends on early, sustained and neurophysiology-driven rehabilitation. Rehabilitation not only prevents secondary complications but also shapes the central and peripheral microenvironment required for reinnervation. Early postoperative care focuses on edema control, pain modulation, protective splinting and maintenance of passive mobility, establishing the biomechanical and neurobiological conditions for axonal regeneration. As reinnervation emerges, therapy transitions to progressive sensorimotor re-education, including graded sensory retraining, mirror-based visual feedback, bilateral tasks and neuromuscular facilitation to reverse cortical disorganization and reactivate functional motor units. Advanced rehabilitation incorporates task-specific practice, proprioceptive enrichment, neurocognitive methods and technology-assisted interventions such as neuromuscular electrical stimulation,
virtual reality and biofeedback, all of which exploit activity-dependent plasticity to refine fine motor control. Effective management requires close collaboration among surgeons, physiotherapists and occupational therapists to align surgical strategies with biological regeneration timelines and individualized therapy goals. This review synthesizes current evidence from neurobiology, surgical reconstruction and rehabilitation science, emphasizing the integration of sensory re-education and neuroplasticity-based techniques to enhance long-term hand function following upper-limb peripheral nerve injuries.

Flexor tendon injuries of the hand are a common yet complex clinical challenge in reconstructive surgery, predominantly affecting young, working-age individuals and often resulting in significant functional impairment. Successful management requires a precise surgical approach combined with a structured, zone-specific rehabilitation protocol to restore optimal hand function. A one-year retrospective study was conducted in the Clinic of Plastic Surgery and Reconstructive Microsurgery at the Clinical Emergency Hospital Bucharest, reviewing the medical records of all patients admitted with traumatic flexor tendon injuries of the upper limb. A total of 58 patients with surgically confirmed flexor tendon injuries were included. Collected data encompassed demographic information, injury mechanism and anatomical location, zone classification, associated neurovascular injuries, timing and type of surgical intervention, and the rehabilitation protocols applied. All patients underwent operative treatment, followed by individualized rehabilitation programs tailored to the anatomical zone and severity of the injury. The data were analysed to identify patterns in injury aetiology, characteristics, and treatment strategies. These findings were compared with current literature and formed the basis for the development of a comprehensive, standardized rehabilitation protocol for flexor tendon injuries of the upper limb.