Semin Plast Surg 2015; 29(01): 062-072
DOI: 10.1055/s-0035-1544166
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Targeted Muscle Reinnervation and Advanced Prosthetic Arms

Jennifer E. Cheesborough
1  Division of Plastic and Reconstructive Surgery, Northwestern University, Chicago, Illinois
,
Lauren H. Smith
2  Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois
3  Department of Biomedical Engineering, Northwestern University, Chicago, Illinois
,
Todd A. Kuiken
2  Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois
3  Department of Biomedical Engineering, Northwestern University, Chicago, Illinois
4  Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois
,
Gregory A. Dumanian
1  Division of Plastic and Reconstructive Surgery, Northwestern University, Chicago, Illinois
› Author Affiliations
Further Information

Publication History

Publication Date:
04 February 2015 (online)

Abstract

Targeted muscle reinnervation (TMR) is a surgical procedure used to improve the control of upper limb prostheses. Residual nerves from the amputated limb are transferred to reinnervate new muscle targets that have otherwise lost their function. These reinnervated muscles then serve as biological amplifiers of the amputated nerve motor signals, allowing for more intuitive control of advanced prosthetic arms. Here the authors provide a review of surgical techniques for TMR in patients with either transhumeral or shoulder disarticulation amputations. They also discuss how TMR may act synergistically with recent advances in prosthetic arm technologies to improve prosthesis controllability. Discussion of TMR and prosthesis control is presented in the context of a 41-year-old man with a left-side shoulder disarticulation and a right-side transhumeral amputation. This patient underwent bilateral TMR surgery and was fit with advanced pattern-recognition myoelectric prostheses.