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Targeted Reinnervation Strategies to Restore Upper Limb Function

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Rehabilitative Surgery

Abstract

Targeted muscle reinnervation (TMR) combines surgery and engineering to restore intuitive control of upper limb function. Advances in bioprostheses, myoelectric systems, and reconstructive surgery have allowed patients to achieve a greater range of complex functional movements. The collaborative effort of surgeons, bioengineers, and rehabilitation specialists has transformed TMR into a promising option for select upper limb amputees.

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References

  1. Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Arch Phys Med Rehabil. 2008;89:422–9.

    Article  PubMed  Google Scholar 

  2. Stansbury LG, Lalliss SJ, Branstetter JG, Bagg MR, Holcomb JB. Amputations in U.S. military personnel in the current conflicts in Afghanistan and Iraq. J Orthop Trauma. 2008;22:43–6.

    Article  PubMed  Google Scholar 

  3. Krueger CA, Wenke JC, Ficke JR. Ten years at war: comprehensive analysis of amputation trends. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S438–44.

    Article  PubMed  Google Scholar 

  4. Tintle SM, Baechler MF, Nanos 3rd GP, Forsberg JA, Potter BK. Traumatic and trauma-related amputations: part II: upper extremity and future directions. J Bone Joint Surg Am. 2010;92:2934–45.

    Article  PubMed  Google Scholar 

  5. Hanley MA, Ehde DM, Jensen M, Czerniecki J, Smith DG, Robinson LR. Chronic pain associated with upper-limb loss. Am J Phys Med Rehabil. 2009;88:742–51; quiz 752, 779.

    Article  PubMed  PubMed Central  Google Scholar 

  6. McKechnie PS, John A. Anxiety and depression following traumatic limb amputation: a systematic review. Injury. 2014;45:1859–66.

    Article  CAS  PubMed  Google Scholar 

  7. Schultz AE, Kuiken TA. Neural interfaces for control of upper limb prostheses: the state of the art and future possibilities. PM R. 2011;3:55–67.

    Article  PubMed  Google Scholar 

  8. Childress DS. Closed-loop control in prosthetic systems: historical perspective. Ann Biomed Eng. 1980;8:293–303.

    Article  CAS  PubMed  Google Scholar 

  9. Shores JT, Brandacher G, Lee WA. Hand and upper extremity transplantation: an update of outcomes in the worldwide experience. Plast Reconstr Surg. 2014;135:351e–60.

    Article  Google Scholar 

  10. Elliott RM, Tintle SM, Levin LS. Upper extremity transplantation: current concepts and challenges in an emerging field. Curr Rev Musculoskelet Med. 2014;7:83–8.

    Article  PubMed  Google Scholar 

  11. Kuiken TA, Li G, Lock BA, et al. Targeted muscle reinnervation for real-time myoelectric control of multifunction artificial arms. JAMA. 2009;301:619–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Luff AR, Webb SN. Electromyographic activity in the cross-reinnervated soleus muscle of unrestrained cats. J Physiol. 1985;365:13–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Nagano A, Tsuyama N, Ochiai N, Hara T, Takahashi M. Direct nerve crossing with the intercostal nerve to treat avulsion injuries of the brachial plexus. J Hand Surg Am. 1989;14:980–5.

    Article  CAS  PubMed  Google Scholar 

  14. Miller LA, Stubblefield KA, Lipschutz RD, Lock BA, Kuiken TA. Improved myoelectric prosthesis control using targeted reinnervation surgery: a case series. IEEE Trans Neural Syst Rehabil Eng. 2008;16:46–50.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Zhou P, Lowery MM, Englehart KB, et al. Decoding a new neural machine interface for control of artificial limbs. J Neurophysiol. 2007;98:2974–82.

    Article  PubMed  Google Scholar 

  16. Scheme E, Englehart K. Electromyogram pattern recognition for control of powered upper-limb prostheses: state of the art and challenges for clinical use. J Rehabil Res Dev. 2011;48:643–59.

    Article  PubMed  Google Scholar 

  17. Weir RF, Troyk PR, DeMichele GA, Kerns DA, Schorsch JF, Maas H. Implantable myoelectric sensors (IMESs) for intramuscular electromyogram recording. IEEE Trans Biomed Eng. 2009;56:159–71.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Schwartz AB, Cui XT, Weber DJ, Moran DW. Brain-controlled interfaces: movement restoration with neural prosthetics. Neuron. 2006;52:205–20.

    Article  CAS  PubMed  Google Scholar 

  19. Dumanian GA, Ko JH, O’Shaughnessy KD, Kim PS, Wilson CJ, Kuiken TA. Targeted reinnervation for transhumeral amputees: current surgical technique and update on results. Plast Reconstr Surg. 2009;124:863–9.

    Article  CAS  PubMed  Google Scholar 

  20. Cheesborough JE, Smith LH, Kuiken TA, Dumanian GA. Targeted muscle reinnervation and advanced prosthetic arms. Semin Plast Surg. 2015;29:62–72.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Cheesborough JE, Souza JM, Dumanian GA, Bueno Jr RA. Targeted muscle reinnervation in the initial management of traumatic upper extremity amputation injury. Hand (N Y). 2014;9:253–7.

    Article  Google Scholar 

  22. Hebert JS, Olson JL, Morhart MJ, et al. Novel targeted sensory reinnervation technique to restore functional hand sensation after transhumeral amputation. IEEE Trans Neural Syst Rehabil Eng. 2014;22:765–73.

    PubMed  Google Scholar 

  23. Kuiken TA, Miller LA, Lipschutz RD, et al. Targeted reinnervation for enhanced prosthetic arm function in a woman with a proximal amputation: a case study. Lancet. 2007;369:371–80.

    Article  PubMed  Google Scholar 

  24. Kuiken TA, Marasco PD, Lock BA, Harden RN, Dewald JP. Redirection of cutaneous sensation from the hand to the chest skin of human amputees with targeted reinnervation. Proc Natl Acad Sci U S A. 2007;104:20061–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Kuiken T. Targeted reinnervation for improved prosthetic function. Phys Med Rehabil Clin N Am. 2006;17:1–13.

    Article  PubMed  Google Scholar 

  26. Pierce Jr RO, Kernek CB, Ambrose 2nd TA. The plight of the traumatic amputee. Orthopedics. 1993;16:793–7.

    PubMed  Google Scholar 

  27. Souza JM, Cheesborough JE, Ko JH, Cho MS, Kuiken TA, Dumanian GA. Targeted muscle reinnervation: a novel approach to postamputation neuroma pain. Clin Orthop Relat Res. 2014;472:2984–90.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kim PS, Ko JH, O’Shaughnessy KK, Kuiken TA, Pohlmeyer EA, Dumanian GA. The effects of targeted muscle reinnervation on neuromas in a rabbit rectus abdominis flap model. J Hand Surg Am. 2012;37:1609–16.

    Article  PubMed  Google Scholar 

  29. Ko JH, Kim PS, O’Shaughnessy KD, Ding X, Kuiken TA, Dumanian GA. A quantitative evaluation of gross versus histologic neuroma formation in a rabbit forelimb amputation model: potential implications for the operative treatment and study of neuromas. J Brachial Plex Peripher Nerve Inj. 2011;6:8.

    PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, 21287, USA

    Victor W. Wong MD & Richard J. Redett MD

Authors
  1. Victor W. Wong MD
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  2. Richard J. Redett MD
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Corresponding author

Correspondence to Richard J. Redett MD .

Editor information

Editors and Affiliations

  1. Institute for Advanced Reconstruction, The Plastic Surgery Center, Shrewsbury, New Jersey, USA

    Andrew I. Elkwood

  2. Institute for Advanced Reconstruction, The Plastic Surgery Center, Shrewsbury, New Jersey, USA

    Matthew Kaufman

  3. Institute for Advanced Reconstruction, The Plastic Surgery Center, Shrewsbury, New Jersey, USA

    Lisa F. Schneider

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© 2017 Springer International Publishing Switzerland

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Wong, V.W., Redett, R.J. (2017). Targeted Reinnervation Strategies to Restore Upper Limb Function. In: Elkwood, A., Kaufman, M., Schneider, L. (eds) Rehabilitative Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-41406-5_22

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  • DOI: https://doi.org/10.1007/978-3-319-41406-5_22

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-41404-1

  • Online ISBN: 978-3-319-41406-5

  • eBook Packages: MedicineMedicine (R0)

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