Long-term functional and clinical outcome of combined targeted muscle reinnervation and osseointegration for functional bionic reconstruction in transhumeral amputees: a case series

Authors

  • Agnes Sturma Degree Program Physiotherapy, Department of Health Sciences, University of Applied Sciences FH Campus Vienna, Vienna, Austria; Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria
  • Anna Boesendorfer Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria
  • Clemens Gstoettner Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria; Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria
  • Benedikt Baumgartner Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria
  • Stefan Salminger AUVA Trauma Hospital Lorenz Böhler—European Hand Trauma Center, Vienna, Austria
  • Dario Farina Department of Bioengineering, Imperial College London, London, UK
  • Rickard Brånemark Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; K. Lisa Yang Center for Bionics, MIT Media Lab, Massachusetts Institute of Technology, Cambridge, USA
  • Ivan Vujaklija Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
  • Gerhard M. Hobusch Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
  • Oskar C. Aszmann Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria; Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria

DOI:

https://doi.org/10.2340/jrm.v56.34141

Keywords:

amputation, function, osseointegration, bone anchored prosthesis, targeted muscle reinnervation, transhumeral, upper extremity, case series

Abstract

Objective: To describe and evaluate the combination of osseointegration and nerve transfers in 3 transhumeral amputees.

Design: Case series.

Patients: Three male patients with a unilateral traumatic transhumeral amputation.

Methods: Patients received a combination of osseointegration and targeted muscle reinnervation surgery. Rehabilitation included graded weight training, range of motion exercises, biofeedback, table-top prosthesis training, and controlling the actual device. The impairment in daily life, health-related quality of life, and pain before and after the intervention was evaluated in these patients. Their shoulder range of motion, prosthesis embodiment, and function were documented at a 2- to 5-year follow-up.

Results: All 3 patients attended rehabilitation and used their myoelectric prosthesis on a daily basis. Two patients had full shoulder range of motion with the prosthesis, while the other patient had 55° of abduction and 45° of anteversion. They became more independent in their daily life activities after the intervention and incorporated their prosthesis into their body scheme to a high extent.

Conclusion: These results indicate that patients can benefit from the combined procedure. However, the patients’ perspective, risks of the surgical procedures, and the relatively long rehabilitation procedure need to be incorporated in the decision-making.

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2024-05-21

How to Cite

Sturma, A., Boesendorfer, A., Gstoettner, C., Baumgartner, B. ., Salminger, S., Farina, D., … Aszmann, O. (2024). Long-term functional and clinical outcome of combined targeted muscle reinnervation and osseointegration for functional bionic reconstruction in transhumeral amputees: a case series. Journal of Rehabilitation Medicine, 56, jrm34141. https://doi.org/10.2340/jrm.v56.34141

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Vol. 56 (2024)

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Copyright (c) 2024 Agnes Sturma, Anna Boesendorfer, Clemens Gstoettner, Benedikt Baumgartner, Stefan Salminger, Dario Farina, Rickard Brånemark, Ivan Vujaklija, Gerhard M. Hobusch, Oskar C. Aszmann

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