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Related Experiment Video

Updated: Jul 9, 2026

Targeted Muscle Reinnervation: Surgical Protocol for a Randomized Controlled Trial in Postamputation Pain
03:26

Targeted Muscle Reinnervation: Surgical Protocol for a Randomized Controlled Trial in Postamputation Pain

Published on: March 8, 2024

Targeted Muscle Reinnervation for Intuitive Prosthetic Control.

Nitay Maile1, Laura Ferrante2, Dario Farina2

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

Muscle & Nerve
|July 8, 2026
PubMed
Summary

Targeted muscle reinnervation (TMR) improves bionic arm control by surgically rewiring nerves to enhance prosthetic function. This technique reestablishes neural pathways, enabling more intuitive and precise control for amputees.

Keywords:
bionic reconstructionnerve transferneuromuscular interfacetargeted muscle reinnervationupper extremity amputation

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Area of Science:

  • Biomedical Engineering
  • Neuroscience
  • Rehabilitation Medicine

Background:

  • Advancements in medical technology offer new solutions for limb amputations.
  • Targeted muscle reinnervation (TMR) has been used for over 20 years to improve prosthetic control.
  • TMR creates a neuromuscular interface by rerouting nerves to new muscle targets.

Purpose of the Study:

  • To provide a comprehensive review of Targeted Muscle Reinnervation (TMR) for prosthetic control.
  • Discuss patient selection, surgical techniques, and rehabilitation for TMR.
  • Explore the neurophysiological principles, current technologies, and future prospects of TMR.

Main Methods:

  • Review of existing literature on Targeted Muscle Reinnervation (TMR).
  • Analysis of neurophysiological principles underlying TMR.
  • Discussion of current and emerging technologies in prosthetic control.

Main Results:

  • TMR enables intuitive prosthetic control by reestablishing neural pathways via electromyographic (EMG) signals.
  • It increases available signal sites and allows control based on central motor intent, especially crucial for high upper-limb amputations.
  • High-density EMG and implantable electrodes further enhance signal acquisition and control capabilities.

Conclusions:

  • TMR significantly enhances the intuitive control of myoelectric prostheses.
  • The technique offers a viable solution for limited signal acquisition in high upper-limb amputations.
  • Future developments in TMR and related technologies promise greater human-machine integration.