Video Gallery

Video Gallery

Welcome to the AAOS Video Gallery, providing an enhanced viewing experience of AAOS video content.

To View the Video

Login

You must be logged in to view this video. Please log in and try again.

Targeted Muscle Reinnervation and Its Role in Acute Management of Above Elbow Amputations

March 01, 2017

Contributors: Mark Adam Tait, MD; John White Bracey, MD; Raymond Glenn Gaston, MD; Bryan J. Loeffler, MD

Targeted muscle reinnervation (TMR) is a surgical technique that can provide patients intuitive myoelectric prosthetic control as well as prevention of, or relief from, neuroma associated pain. This technique involves nerve transfers that increase the number of available surface electromyography (EMG) targets leading to improved patient control of myoelectric prosthesis. Additionally, utilization of EMG pattern recognition has evolved in conjunction with TMR to further improve prosthetic control. Early case studies seem to indicate that TMR is successful in prevention of early neuroma formation after amputation and is a highly effective surgical intervention for the treatment of painful neuromas. The technique of TMR in the above elbow amputee has been well described. These advances in surgical and prosthetic technique have led to implementation of TMR in all patients with transhumeral amputations at our facility during the initial hospitalization following their injury as discussed by other institutions. In this video, we will discuss technical aspects of TMR in above elbow amputees as well as the importance of a patient care team including physicians, therapists, and prosthetic designers. We will present two patients who underwent TMR after traumatic transhumeral amputation. Both patients underwent surgical intervention shortly after initial injury. In both cases muscle reinnervation occurred leading to reliable EMG signals for control of a myoelectric prosthesis. The intuitive nature of TMR led to early control of the prosthesis. In both cases patients were able to control a myoelectric prosthesis with use of reinnervated muscles using pattern recognition based myoelectric prosthesis and neither has had painful neuroma formation.

Results for "Neurovascular"

1 of 2
1 of 2