title: Targeted muscle reinnervation and advanced prosthetic arms.
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.
authors: Division of Plastic and Reconstructive Surgery, Northwestern University, Chicago, Illinois.
authors: Jennifer E
authors: JE
authors: Cheesborough
authors: Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois ; Department of Biomedical Engineering, Northwestern University, Chicago, Illinois.
authors: Lauren H
authors: LH
authors: Smith
authors: Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois ; Department of Biomedical Engineering, Northwestern University, Chicago, Illinois ; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois.
authors: Todd A
authors: TA
authors: Kuiken
authors: Division of Plastic and Reconstructive Surgery, Northwestern University, Chicago, Illinois.
authors: Gregory A
authors: GA
authors: Dumanian
keywords: amputation; prosthetic limb; shoulder disarticulation; targeted muscle reinnervation; transhumeral amputation