Targeted Muscle Reinnervation: A Novel Approach to Postamputation Neuroma Pain

Abstract

None of the 26 patients who underwent TMR demonstrated evidence of new neuroma pain after the procedure, and all but one of the 15 patients who presented with preoperative neuroma pain experienced complete relief of pain in the distribution of the transferred nerves. TMR offers a novel and potentially more effective therapy for the management of neuroma pain after limb amputation.

Targeted Muscle Reinnervation in the Upper Extremity Amputee: A Technical Roadmap

“…The same pattern of nerve transfers was used for all 16 transhumeral patients, whereas 7 different nerve transfer combinations were used in the 10 shoulder disarticulation TMR patients included in the study. 3 …”

“…1,2 In addition to the prosthetic control benefits, TMR is a potential treatment for postamputation neuroma pain. 3 Because TMR is most frequently performed in the transhumeral and shoulder disarticulation patient, the surgical approach to TMR at these amputation levels serves as the focus for this review.…”

Traction Neurectomy for Treatment of Painful Residual Limb Neuroma in Lower Extremity Amputees

“…The literature abounds with proposed surgical treatments for symptomatic neuroma. Muscle, 4,5 bone, 6,7 or vein implantation, 8,9 centro-central coaptation, 10,11 targeted nerve implantation, 12 and targeted muscle reinnervation, 13 among others, have been advocated based on theoretical arguments and encouraging case series data. However, in the absence of an evidence-based consensus solution, many surgeons have used traction neurectomy as the most straightforward and least invasive surgical technique for neuroma management.…”

The prospects of prosthetics/robotization of lost functions of the human hand based on electromyographic autosignal

“…Одним из наиболее необычных подходов является метод целенаправленной реиннервации мышц (TMR, targeted muscle reinnervation), суть которой сводится к тому, что нервы от более несуществующих мышц конечности (вследствие травматической ампутации) хирургически перенаправляются к оставшимся мышцам, которые становятся «бесполезными» после потери конечности (Souza, 2014). Например, при плечевой дизартикуляции (удалении всего плечевого сустава и руки ниже него) мышцы, управляющие этим суставом, такие как головки большой грудной мышцы, могут быть хирургически реиннервированы нервами, которые обычно управляют мышцами руки.…”