Pierrie Sarah N, Gaston R Glenn, Loeffler Bryan J
Department of Orthopaedics, San Antonio Military Medical Center, Ft. Sam Houston, TX.
Carolinas Medical Center, Atrium Health, Charlotte, NC; Reconstructive Center for Lost Limbs, OrthoCarolina Hand and Wrist Center, Charlotte, NC.
J Hand Surg Am. 2019 Jun;44(6):525.e1-525.e8. doi: 10.1016/j.jhsa.2018.11.019. Epub 2019 Feb 4.
Targeted muscle reinnervation (TMR) is a surgical technique that improves modern myoelectric prosthesis functionality and plays an important role in the prevention and treatment of painful postamputation neuromas. Originally described for transhumeral amputations and shoulder disarticulations, the technique is being adapted for treatment of transtibial, transfemoral, transradial, and partial hand amputees. We describe a new technique for forearm TMR following transradial amputation with an emphasis on selecting nerve transfer patterns, managing sensory nerves, improving terminal soft tissue coverage, and employing pattern recognition technology.
靶向肌肉再支配(TMR)是一种外科技术,可改善现代肌电假肢的功能,并在预防和治疗截肢后疼痛性神经瘤方面发挥重要作用。该技术最初是针对经肱骨截肢和肩关节离断术描述的,目前正被应用于治疗经胫骨、经股骨、经桡骨截肢以及部分手部截肢患者。我们描述了一种经桡骨截肢后前臂TMR的新技术,重点在于选择神经转移模式、处理感觉神经、改善末端软组织覆盖以及应用模式识别技术。