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Related Experiment Video

Updated: Mar 8, 2026

Surface Electromyographic Biofeedback as a Rehabilitation Tool for Patients with Global Brachial Plexus Injury Receiving Bionic Reconstruction
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Algorithm for bionic hand reconstruction in patients with global brachial plexopathies.

Laura A Hruby1,2, Agnes Sturma1,2,3, Johannes A Mayer1

  • 1Christian Doppler Laboratory for Restoration of Extremity Function.

Journal of Neurosurgery
|January 18, 2017
PubMed
Summary
This summary is machine-generated.

Bionic reconstruction, combining nerve transfers with prosthetic limbs, restores useful hand function for severe brachial plexus injuries when biological options fail. This innovative approach offers a new hope for regaining arm and hand capabilities.

Keywords:
ADL = activities of daily livingARAT = Action Research Arm TestBP, BPI = brachial plexus, BP injuryDASH = Disabilities of the Arm, Shoulder, and HandEMG, sEMG = electromyographic, surface EMGFFMT = free functional muscle transplantationSHAP = Southampton Hand Assessment ProcedureVAS = visual analog scalebrachial plexus injuryelective amputationperipheral nerveprosthetic rehabilitationprosthetic replacement

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Area of Science:

  • Neurosurgery
  • Biomedical Engineering
  • Rehabilitation Medicine

Background:

  • Global brachial plexus lesions with multiple root avulsions represent severe nerve injuries, often resulting in lifelong disability and loss of hand function.
  • While traditional reconstructions can stabilize the shoulder and restore some arm function, achieving biological hand function remains a significant challenge.
  • Bionic reconstruction offers a novel approach to overcome biological limitations by integrating advanced prosthetics with nerve and muscle transfers.

Purpose of the Study:

  • To present a treatment algorithm for bionic hand reconstruction in patients with global brachial plexopathies.
  • To report on the management and long-term functional outcomes of patients undergoing this innovative bionic reconstruction.
  • To evaluate the efficacy of bionic reconstruction in restoring hand function when biological treatments are not viable.

Main Methods:

  • A cohort of 34 patients with posttraumatic global brachial plexopathies and loss of hand function were evaluated.
  • Sixteen patients (47%) were selected for bionic reconstruction due to a lack of alternative treatment options.
  • The bionic reconstruction involved a progressive algorithm focused on optimizing the biotechnological interface for prosthetic integration, including selective nerve and muscle transfers and prosthetic hand replacement.

Main Results:

  • Partial hand function was successfully restored in 5 patients who completed functional assessments following bionic reconstruction.
  • Significant improvements were observed in functional outcome scores: Action Arm Research Test (ARAT) scores increased (p=0.043) and Southampton Hand Assessment Procedure (SHAP) scores improved (p=0.042).
  • Patient-reported disability decreased, as indicated by a significant reduction in Disabilities of the Arm, Shoulder, and Hand (DASH) scores (p=0.042).

Conclusions:

  • The developed algorithm for bionic reconstruction effectively restores useful hand function in patients with global brachial plexopathies.
  • This approach provides a viable solution for individuals with stiff, functionless, and insensate hands resulting from severe nerve injuries where traditional methods are insufficient.
  • Bionic reconstruction represents a significant advancement in managing complex extremity trauma, offering improved quality of life through functional restoration.