Kubiak Carrie A, Adidharma Widya, Kung Theodore A, Kemp Stephen W P, Cederna Paul S, Vemuri Chandu
Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, MI.
Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, MI.
Ann Vasc Surg. 2022 Feb;79:421-426. doi: 10.1016/j.avsg.2021.08.014. Epub 2021 Oct 14.
Over 185,000 limb amputations are performed in the United States annually, many of which are due to the sequelae of peripheral vascular disease. Symptomatic neuromas remain a significant source of postamputation morbidity and contribute to both phantom limb (PLP) and residual limb pain (RLP). While many interventions have been proposed for the treatment of symptomatic neuromas, conventional methods lead to a high incidence of neuroma recurrence. Furthermore, these existing methods do not facilitate an ability to properly interface with myoelectric prosthetic devices. The Regenerative Peripheral Nerve Interface (RPNI) was developed to overcome these limitations. The RPNI consists of an autologous free muscle graft secured around the end of a transected nerve. The muscle graft provides regenerating axons with end organs to reinnervate, thereby preventing neuroma formation. We have shown that this simple, reproducible, and safe surgical technique successfully treats and prevents neuroma formation in major limb amputations. In this paper, we describe RPNI surgery in the setting of major limb amputation and highlight the promising results of RPNIs in our animal and clinical studies.
在美国，每年进行超过18.5万例肢体截肢手术，其中许多是由外周血管疾病的后遗症导致的。症状性神经瘤仍然是截肢后发病的重要原因，并导致幻肢痛（PLP）和残肢痛（RLP）。虽然已经提出了许多治疗症状性神经瘤的干预措施，但传统方法导致神经瘤复发率很高。此外，这些现有方法不利于与肌电假肢装置进行适当的对接。再生周围神经接口（RPNI）的开发就是为了克服这些局限性。RPNI由围绕横断神经末端固定的自体游离肌肉移植物组成。肌肉移植物为再生轴突提供终末器官以重新支配，从而防止神经瘤形成。我们已经表明，这种简单、可重复且安全的手术技术成功地治疗并预防了大肢体截肢中的神经瘤形成。在本文中，我们描述了大肢体截肢情况下的RPNI手术，并强调了RPNI在我们的动物和临床研究中的 promising 结果。 （注：“promising”此处未准确翻译出其含义，因原文有误，可能正确的词是“promising”，应译为“有前景的”）
