Kugach Kelly A, Novikova Camden, Schwartz Rachel, Capito Anthony, Apel Peter J
From the Department of Orthopaedic Surgery, Foot and Ankle, Carilion Clinic, Roanoke, VA.
Musculoskeletal Education and Research Center, Department of Orthopaedic Surgery, Institute for Orthopaedics and Neurosciences, Carilion Clinic, Roanoke, VA.
Plast Reconstr Surg Glob Open. 2025 Aug 4;13(8):e7000. doi: 10.1097/GOX.0000000000007000. eCollection 2025 Aug.
Painful mononeuropathies in nonamputation patients are prevalent and have historically been difficult to treat. Targeted muscle reinnervation (TMR) is known to reduce pain in amputation patients and those with neuroma formation. However, there is little known about TMR in nonamputation patients, and there is a lack of described techniques for performing TMR in lower extremity nonamputation patients. This article presents techniques for TMR in the lower extremity for nonamputation patients using cadaver dissection and surgical videos. The authors describe tips and tricks for performing these procedures, and the rationale for selecting recipient muscles for TMR in the lower extremity in nonamputation patients is reviewed.
非截肢患者的疼痛性单神经病很常见,并且一直以来都难以治疗。已知靶向肌肉再支配术(TMR)可减轻截肢患者和患有神经瘤患者的疼痛。然而,对于非截肢患者的TMR了解甚少,并且缺乏在下肢非截肢患者中进行TMR的描述技术。本文介绍了使用尸体解剖和手术视频对非截肢患者进行下肢TMR的技术。作者描述了执行这些手术的技巧和窍门,并回顾了在非截肢患者中为下肢TMR选择受区肌肉的基本原理。