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Targeted Muscle Reinnervation for Prosthetic Control.

Konstantin D Bergmeister1, Stefan Salminger2, Oskar C Aszmann2

  • 1Clinical Laboratory for Bionic Extremity Reconstruction, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria; Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital St. Poelten, St. Poelten, Austria.

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Targeted muscle reinnervation (TMR) surgery reroutes nerves to residual muscles after amputation. This innovative procedure enhances prosthetic control by increasing independent muscle signals for improved functionality.

Keywords:
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Area of Science:

  • * Regenerative Medicine
  • * Biomedical Engineering
  • * Surgical Innovation

Background:

  • * Amputation often results in nerves without muscle targets, hindering prosthetic control.
  • * Targeted muscle reinnervation (TMR) offers a solution by redirecting these nerves.
  • * Improved prosthetic functionality is a key goal in limb reconstruction.

Purpose of the Study:

  • * To outline indications for TMR to enhance prosthetic control.
  • * To present standard nerve transfer matrices for specific amputee levels.
  • * To describe the complete perioperative process of TMR.

Main Methods:

  • * Surgical transfer of nerves without muscle targets to residual stump muscles.
  • * Development of nerve transfer matrices for transhumeral and glenohumeral amputees.
  • * Comprehensive description of preoperative testing, surgical approach, and postoperative rehabilitation.

Main Results:

  • * TMR increases the number of independent muscle signals available for prosthetic control.
  • * Standardized nerve transfer matrices facilitate surgical planning and execution.
  • * Perioperative protocols ensure optimal patient outcomes.

Conclusions:

  • * Targeted muscle reinnervation is a viable surgical option for improving prosthetic control in amputees.
  • * Future advancements may integrate TMR with implantable electromyographic technology for even greater functionality.
  • * This approach represents a significant step forward in prosthetic limb technology.