Aman Martin, Sporer Matthias E, Gstoettner Clemens, Prahm Cosima, Hofer Christian, Mayr Winfried, Farina Dario, Aszmann Oskar C
CD Laboratory for the Restoration of Extremity Function, Department of Surgery, Medical University of Vienna, Vienna, Austria.
Division of Biomedical Research, Medical University of Vienna, Vienna, Austria.
Artif Organs. 2019 Feb;43(2):109-118. doi: 10.1111/aor.13422.
Even though the hand comprises only 1% of our body weight, about 30% of our central nervous systems (CNS) capacity is related to its control. The loss of a hand thus presents not only the loss of the most important tool allowing us to interact with our environment, but also leaves a dramatic sensory-motor deficit that challenges our CNS. Reconstruction of hand function is therefore not only an essential part of restoring body integrity and functional wholeness but also closes the loop of our neural circuits diminishing phantom sensation and neural pain. If biology fails to restore meaningful function, today we can resort to complex mechatronic replacement that have functional capabilities that in some respects even outperform biological alternatives, such as hand transplantation. As with replantation and transplantations, the challenge of bionic replacement is connecting the target with the CNS to achieve natural and intuitive control. In recent years, we have developed a number of strategies to improve neural interfacing, signal extraction, interpretation and stable mechanical attachment that are important parts of our current research. This work gives an overview of recent advances in bionic reconstruction, surgical refinements over technological interfacing, skeletal fixation, and modern rehabilitation tools that allow quick integration of prosthetic replacement.
尽管手仅占我们体重的1%，但我们中枢神经系统（CNS）约30%的能力与对手的控制有关。因此，失去一只手不仅意味着失去了让我们与环境互动的最重要工具，还会留下严重的感觉运动缺陷，给我们的中枢神经系统带来挑战。因此，手部功能重建不仅是恢复身体完整性和功能整体性的重要组成部分，还能闭合我们的神经回路，减少幻肢感觉和神经疼痛。如果生物学方法无法恢复有意义的功能，如今我们可以采用复杂的机电替代方案，其功能在某些方面甚至优于生物替代方案，比如手部移植。与再植和移植一样，仿生替代的挑战在于将目标与中枢神经系统连接起来，以实现自然直观的控制。近年来，我们已经开发出多种策略来改善神经接口、信号提取、解读以及稳定的机械附着，这些都是我们当前研究的重要组成部分。本文综述了仿生重建、技术接口手术改进、骨骼固定以及现代康复工具方面的最新进展，这些工具能够实现假肢替代的快速整合。
