Kalff M N, Witowski V, Hoursch V, Kirsten N, Niehage L, Kramer H, Gardetto A, Sehmisch S, Ernst J
Klinik für Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland.
Unfallchirurgie (Heidelb). 2024 Sep;127(9):626-636. doi: 10.1007/s00113-024-01466-6. Epub 2024 Aug 13.
Despite intensive research and development of systems for restoration of sensory information, these have so far only been the subject of study protocols. A new noninvasive feedback system translates pressure loads on the forefoot and hindfoot into gait-synchronized vibrotactile stimulation of a defined skin area. To increase the authenticity, this treatment can be supplemented by a surgical procedure. Targeted sensory reinnervation (TSR) describes a microsurgical procedure in which a defined skin area on the amputated stump of the residual limb is first denervated and then reinnervated by a specific, transposed sensory nerve harvested from the amputated part of the limb. This creates a sensory interface at the residual stump. This article presents the clinical and orthopedic technical treatment pathway with this innovative vibrotactile feedback system and explains in detail the surgical procedure of TSR after amputation of the lower limb.
尽管对感觉信息恢复系统进行了深入的研发,但迄今为止这些系统仅处于研究方案的阶段。一种新型的非侵入性反馈系统可将前足和后足上的压力负荷转化为对特定皮肤区域的步态同步振动触觉刺激。为提高真实性,这种治疗可通过外科手术进行补充。靶向感觉神经再支配(TSR)描述的是一种显微外科手术,其中首先对残肢截肢残端上的特定皮肤区域进行去神经支配,然后通过从肢体截肢部分获取的特定的、移位的感觉神经进行再支配。这在残端处创建了一个感觉界面。本文介绍了使用这种创新的振动触觉反馈系统的临床和矫形技术治疗途径,并详细解释了下肢截肢后TSR的外科手术过程。