Updates in Targeted Sensory Reinnervation for Upper Limb Amputation

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• 作者：Jacqueline S. Hebert (1)
  Kate Elzinga (2)
  K. Ming Chan (3)
  Jaret Olson (4)
  Michael Morhart (5)
  
• 关键词：Targeted sensory reinnervation ; Targeted motor reinnervation ; Upper limb amputation ; Upper limb prosthesis ; Sensory outcomes
• 刊名：Current Surgery Reports
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：2
• 期：3
• 全文大小：270 KB
• 作者单位：Jacqueline S. Hebert (1)
  Kate Elzinga (2)
  K. Ming Chan (3)
  Jaret Olson (4)
  Michael Morhart (5)
  
  1. Division of Physical Medicine and Rehabilitation, Glenrose Rehabilitation Hospital, University of Alberta, Rm 1239, 10230-111 Ave, Edmonton, AB, T5G 0B7, Canada
  2. Division of Plastic Surgery, University of Alberta, 2207-8210 111 St NW, Edmonton, AB, T6G 2C7, Canada
  3. Division of Physical Medicine and Rehabilitation, Centre for Neuroscience, 5005 Katz Group Centre, University of Alberta, Edmonton, AB, T5R 2E1, Canada
  4. Division of Plastic Surgery, University of Alberta, 82-8440 112 St NW, 2D3 WMC, Edmonton, AB, T6G 2B7, Canada
  5. Division of Plastic Surgery, University of Alberta, 303 East Tower, 14310 111 Ave NW, Edmonton, AB, T5M 3Z7, Canada
  
• ISSN：2167-4817

文摘

Advanced robotic devices capable of simulating the dexterous ability of the upper limb with an array of internal sensors have raised the enticing prospect of replacing the lost intricate functions of the arm following upper limb amputation. However, a large gap still exists in the application of this technology to the human user. In particular, the ability to provide physiologically relevant sensory feedback—to have the amputee feel the prosthetic hand as their own—has not yet been achieved. Although a number of different approaches are being investigated, targeted sensory reinnervation, a refinement of the original targeted muscle reinnervation procedure, is the most recent and promising development in the effort to create a functional human–machine interface with a closed loop sensory feedback system. This technique aims to re-establish hand sensation on the skin so that it can be readily accessed non-invasively during functional tasks. Recent efforts are being directed towards distributing hand maps widely on the stump without interference of sensations from the native area. In this article, we will review the surgical approaches that have been used for sensory reinnervation in upper arm amputation and compare the resultant outcomes and potential functional utility of the techniques.