Bull Hosp Jt Dis (2013). 2022 Mar;80(1):25-30.
Targeted muscle reinnervation (TMR) is a procedure in which amputated nerves are transferred to motor branches of functionally expendable muscles, which can then serve as "biological amplifiers" of neurologic information. It is a technique that was developed with the primary intent of improving myoelectric prosthesis control in high level upper extremity amputees. Over time, TMR has been shown to confer significant benefits in terms of both residual and phantom limb pain and as such has become a powerful tool in neuroma management in amputees and non-amputees. This review first discusses general principles of amputation management in the upper extremity, including the different types of prosthetics that are available for these patients. The history, rationale, and evolution of TMR will then be outlined, followed by several relevant surgical principles. Finally, the current evidence for and against TMR will be reviewed. Robust data on the functional benefits are still needed, and future studies will continue to clarify its role in both upper and lower extremity amputees.
靶向肌肉神经再支配（TMR）是一种将切断的神经转移到功能可耗尽的肌肉的运动分支的手术，这些肌肉可以作为神经信息的“生物放大器”。该技术的主要目的是改善高水平上肢截肢者的肌电假体控制。随着时间的推移，TMR 在减轻残肢和幻肢痛方面显示出显著的益处，因此成为截肢者和非截肢者神经瘤管理的有力工具。这篇综述首先讨论了上肢截肢管理的一般原则，包括这些患者可用的不同类型的假肢。然后将概述 TMR 的历史、基本原理和演变，接着介绍几个相关的手术原则。最后，将回顾 TMR 的当前证据。仍需要关于功能益处的可靠数据，未来的研究将继续阐明 TMR 在上下肢截肢者中的作用。
