Surke Carsten, Ducommun Dit Boudry Pascal, Vögelin Esther
1 Universitätsklinik für Plastische und Handchirurgie, Inselspital, Bern.
Ther Umsch. 2015 Aug;72(8):487-93. doi: 10.1024/0040-5930/a000706.
The loss of the upper extremity implicates a grave insult in the life of the involved person. To compensate for the loss of function different powered prosthetic devices are available. Ever since their first development 70 years ago numerous improvements in terms of size, weight and wearing comfort have been developed, but issues regarding the control of upper extremity prostheses remain. Slow grasping speed, limited grip positions and especially failure to provide a sensory feedback limit the acceptance in patients. Recent developments are aimed to allow a more intuitive control of the prosthetic device and to provide a sensory feedback to the amputee. Targeted reinnervation reassignes existing muscles to different peripheral nerves thereby enabling them to fulfill alternate functions. Implanting electrodes into muscle bellies of the forearm allows a more accurate control of the prosthesis. Promising results are being achieved by implanting nerve electrodes by establishing bilateral communication between patient and prosthesis. The following review summarizes the current developments of bionic prostheses in the upper extremity.
上肢缺失对患者的生活是一个严重的伤害。为了弥补功能丧失,有不同动力的假肢可供使用。自70年前首次研发以来,假肢在尺寸、重量和佩戴舒适度方面有了许多改进,但上肢假肢的控制问题仍然存在。抓握速度慢、抓握位置有限,尤其是无法提供感觉反馈,限制了患者对假肢的接受度。最近的进展旨在实现对假肢设备更直观的控制,并为截肢者提供感觉反馈。靶向神经再支配将现有肌肉重新分配到不同的周围神经,从而使它们能够发挥替代功能。将电极植入前臂的肌腹可以更精确地控制假肢。通过植入神经电极,在患者和假肢之间建立双边通信,正在取得有希望的结果。以下综述总结了上肢仿生假肢的当前进展。