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Targeted Muscle Reinnervation in Partial Hand Amputations.

Sunishka M Wimalawansa1, Daniel Lygrisse2, Spencer R Anderson1

  • 1Division of Plastic and Reconstructive Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio.

Plastic and Reconstructive Surgery. Global Open
|December 9, 2021
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Summary

Targeted muscle reinnervation (TMR) surgery can effectively treat neuropathic pain after partial hand amputation. This study details TMR techniques for partial hand amputations, showing significant pain reduction in most patients.

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Area of Science:

  • Surgical techniques
  • Pain management
  • Regenerative medicine

Background:

  • Targeted muscle reinnervation (TMR) surgery is established for upper extremity amputations to manage neuropathic pain.
  • Technical descriptions for TMR in partial hand amputations are limited.
  • Neuropathic pain is a common complication following partial hand loss.

Purpose of the Study:

  • To describe the surgical techniques for Targeted muscle reinnervation (TMR) in various types of partial hand amputations.
  • To provide a reference for surgeons performing TMR on partial hand amputees.
  • To present preliminary outcomes of TMR for partial hand amputations.

Main Methods:

  • Retrospective review of clinical cases undergoing partial hand TMR surgery.
  • Data collection included patient demographics, amputation subtype, nerve transfer details, and pain/functional outcomes.
  • Analysis of 13 patients who underwent partial hand TMR between January 2018 and September 2019.

Main Results:

  • Thirteen patients underwent partial hand TMR, with amputations including ray, trans-metacarpal, and partial hand losses.
  • Twelve out of thirteen patients were successfully weaned off narcotic pain medication.
  • Three patients required ongoing neuromodulator therapy for pain control.

Conclusions:

  • Targeted muscle reinnervation (TMR) is a viable surgical option for managing neuropathic pain in partial hand amputations.
  • The described techniques offer a guide for performing TMR in this patient population.
  • Early results indicate significant potential for pain reduction and improved quality of life.