Article
Surgery
Jialun Li, Tony Chieh-Ting Huang, Arif R. Chaudhry, Sean Cantwell, Steven L. Moran
Summary: This report discusses a surgical solution for cases where the chest wall is depleted of muscle targets, utilizing a neurotized free Vertical Rectus Abdominus Mycocutaneous (VRAM) flap to create a neural interface for targeted muscle reinnervation. The patient gained control of the transferred VRAM after 39 months, successfully operating a custom-fitted myoelectric prosthesis and reducing pain. Such a surgical strategy may have applications in other areas of the body.
Article
Orthopedics
Timothy P. Fowler
Summary: This study aimed to identify and measure the motor entry points (MEPs) to hand interossei muscles in the context of targeted muscle reinnervation (TMR) for digital nerve neuroma management. The study found that motor branches to the second and third palmar interossei muscles were the most accessible and best approached volarly, while motor branches to the dorsal interossei took more direct routes into the muscle, making volar exposure difficult. The length of the nerve proximal to the MEP was short, requiring most of the nerve length for neurorrhaphy to come from the digital nerve.
JOURNAL OF HAND SURGERY-AMERICAN VOLUME
(2022)
Article
Health Care Sciences & Services
Martin Aman, Bahram Biglari, Mirjam Thielen, Arne H. Boecker, Annette Stolle, Daniel Schwarz, Emre Gazyakan, Ulrich Kneser, Leila Harhaus
Summary: Complex regional pain syndrome (CRPS) can lead to a devastating condition where some patients may request amputation due to non-response to existing therapies. This article proposes an advanced algorithm for amputation indications in CRPS patients, combining various factors such as psychiatric assessment, diagnostic hybrid prosthetic fitting, and surgical procedures.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Clinical Neurology
Jenna-Lynn B. Senger, Paige Hardy, Aline Thorkelsson, Shirley Duia, Ralph Hsiao, Stephen W. P. Kemp, Gustavo Tenorio, Mithun Rajshekar, Bradley J. Kerr, K. Ming Chan, Karyne N. Rabey, Christine A. Webber
Summary: The study compared the efficacy of TMR and RPNI surgeries in managing neuroma pain using a rodent model. Both TMR and RPNI surgeries improved pain scores and may be clinically feasible techniques for improving outcomes for patients with nerve injuries or undergoing amputation.
Article
Surgery
Norbert Venantius Kang, Alexander Woollard, Dominika Antonina Michno, Yazan Al-Ajam, Jaclyn Tan, Esther Hansen
Summary: It is crucial for surgeons and patients to fully understand the course and outcomes of this novel surgery prior to undertaking treatment.
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
(2022)
Article
Orthopedics
Emily R. Finkelstein, Helen Hui-Chou, Natalia Fullerton, Jean Jose
Summary: This report demonstrates the potential utility of ultrasound neurography in accurately differentiating the outcomes of TMR surgical procedures. Ultrasound evaluation in patient 1 confirmed successful reinnervation, while patient 2 showed discontinuity of nerve fascicles and poor functional recovery. Early identification of poor TMR outcomes through ultrasound can aid in further surgical planning and improve functional outcomes.
SKELETAL RADIOLOGY
(2023)
Article
Surgery
Ian L. Valerio, Michael Larsen, Kyle R. Eberlin
Summary: Targeted muscle reinnervation is a modern technique that can reduce neuropathic pain in amputees, and utilizing spare parts reconstruction can address limitations in certain amputations. The combination of spare parts reconstruction and targeted muscle reinnervation may lead to fewer occurrences of neuroma and phantom limb pain.
PLASTIC AND RECONSTRUCTIVE SURGERY
(2021)
Article
Engineering, Biomedical
Gang Seo, Ameen Kishta, Emily Mugler, Marc W. Slutzky, Jinsook Roh
Summary: This study found that MyoCI training can reduce arm impairment in stroke survivors by decoupling the trained muscles while leaving other muscles relatively unaffected.
JOURNAL OF NEUROENGINEERING AND REHABILITATION
(2022)
Article
Orthopedics
Shannon Kuruvilla, Christine Schaeffer, Minton T. Cooper, Brent R. DeGeorge
Summary: Despite multiple surgical options for Morton's neuroma, complications are common. This study explores the feasibility of using targeted muscle reinnervation (TMR) to prevent recurrence and demonstrates consistent neurovascular and muscle anatomy for TMR in Morton's neuroma.
FOOT & ANKLE SPECIALIST
(2022)
Article
Cell Biology
Yuanheng Li, Jiangping Huang, Yuling Chen, Shanshan Zhu, Zhen Huang, Lin Yang, Guanglin Li
Summary: Delayed targeted muscle reinnervation can achieve the same restoration effect of nerve function as immediate reinnervation.
NEURAL REGENERATION RESEARCH
(2023)
Article
Anesthesiology
Elizabeth Roth, Allison Linehan, Dorothee Weihrauch, Cheryl Stucky, Quinn Hogan, Gwendolyn Hoben
Summary: Targeted muscle reinnervation (TMR) is an effective clinical intervention for preventing or reducing amputation-related pain, especially when performed immediately after injury. However, the effectiveness of TMR significantly decreases when applied several weeks after injury. A preclinical model was developed to study the mechanisms of pain relief in TMR of amputated nerves.
Article
Health Care Sciences & Services
Martin Aman, Julia J. J. Glaser, Arne H. H. Boecker, Mirjam Thielen, Amr Eisa, Amir K. K. Bigdeli, Emre Gazyakan, Ulrich Kneser, Leila Harhaus
Summary: There are anatomical limitations to some surgical methods for treating neuromas, but providing a neurotizable target for axon ingrowth can be beneficial. Sufficient soft tissue coverage is also important in neuroma therapy. This study demonstrates the use of sensory neurotized free flaps with anatomical constant branches to treat therapy-resistant neuromas with insufficient tissue coverage. Clinical cases and common neurotizable flaps are also presented.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Clinical Neurology
Steven J. Charous, Michael J. Hutz, Samantha E. Bialek, Jane K. Schumacher, Eileen M. Foecking
Summary: The study compared different nerve repair techniques for functional recovery in rat facial nerve injury, with MNN grafting showing promising results in faster return of vibrissae movement and less muscle atrophy compared to other techniques.
FRONTIERS IN NEUROLOGY
(2021)
Review
Peripheral Vascular Disease
John Phair, Krystina Choinski, Dani C. Inglesby, Shawn Diamond, Steven M. Sultan
Summary: This narrative review provides updated recommendations and information on the use of Targeted Muscle Reinnervation (TMR) for chronic pain and phantom limb pain in patients undergoing lower extremity amputation for peripheral artery disease. The review highlights the indications, clinical applications, and surgical technique for TMR, as well as early studies showing positive long-term results.
Article
Engineering, Biomedical
Michael Wand, Morten B. Kristoffersen, Andreas W. Franzke, Jurgen Schmidhuber
Summary: This study demonstrates that state-of-the-art deep neural networks outperform common baseline approaches in regression-based multi-class proportional myoelectric hand prosthesis control. The neural network mapping is analyzed to explain this superiority.
IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING
(2022)
