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Targeted Muscle Reinnervation for Symptomatic Neuromas Utilizing the Terminal Anterior Interosseous Nerve.

Luke J Grome1, Nikhil A Agrawal1, Eric Wang2

  • 1Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine, Houston, Tex.

Plastic and Reconstructive Surgery. Global Open
|August 18, 2020
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Summary

Targeted muscle reinnervation (TMR) using the terminal anterior interosseous nerve (AIN) offers a new treatment for wrist neuromas. This innovative approach shows promise for effectively managing debilitating nerve injuries with minimal complications.

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Area of Science:

  • Neurosurgery
  • Peripheral Nerve Surgery
  • Regenerative Medicine

Background:

  • Wrist sensory nerve trauma frequently results in painful neuromas.
  • Targeted muscle reinnervation (TMR) is an established treatment for neuroma pain.
  • Identifying suitable recipient nerves for TMR is crucial for treatment success.

Purpose of the Study:

  • To evaluate the terminal anterior interosseous nerve (AIN) as a recipient nerve for TMR in treating wrist neuromas.
  • To assess the feasibility and potential benefits of using the distal AIN for TMR.

Main Methods:

  • Cadaveric dissection of superficial wrist sensory nerves and the terminal AIN in 2 specimens.
  • Identification of viable coaptation sites between sensory nerves and the AIN.
  • Application of the demonstrated technique in a subsequent clinical case.

Main Results:

  • Successful dissection and identification of the terminal AIN and relevant wrist sensory nerves.
  • Demonstrated cadaveric feasibility of coapting wrist sensory nerves to the distal AIN.
  • Successful clinical application of the AIN TMR technique for wrist neuroma treatment.

Conclusions:

  • The distal anterior interosseous nerve (AIN) serves as a versatile recipient nerve for targeted muscle reinnervation (TMR).
  • This technique provides a viable surgical option for managing painful wrist neuromas.
  • The described TMR approach using the AIN offers potential for effective treatment with minimal donor-site morbidity.