A Consensus Approach for Targeted Muscle Reinnervation in Amputees

Kyle R. Eberlin, MD; David A. Brown, MD, PhD; R. Glenn Gaston, MD; Grant M. Kleiber, MD; Jason H. Ko, MD, MBA; Stephen J. Kovach, MD; Bryan J. Loeffler, MD; Brendan J. MacKay, MD; Benjamin K. Potter, MD; Margaret S. Roubaud, MD; Jason M. Souza, MD; Ian L. Valerio, MD, MBA; Gregory A. Dumanian, MD

doi:10.1097/GOX.0000000000004928

Plastic and Reconstructive Surgery, Global Open (Apr 2023)

A Consensus Approach for Targeted Muscle Reinnervation in Amputees

Kyle R. Eberlin, MD,
David A. Brown, MD, PhD,
R. Glenn Gaston, MD,
Grant M. Kleiber, MD,
Jason H. Ko, MD, MBA,
Stephen J. Kovach, MD,
Bryan J. Loeffler, MD,
Brendan J. MacKay, MD,
Benjamin K. Potter, MD,
Margaret S. Roubaud, MD,
Jason M. Souza, MD,
Ian L. Valerio, MD, MBA,
Gregory A. Dumanian, MD

Affiliations

Kyle R. Eberlin, MD: From the * Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
David A. Brown, MD, PhD: † Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Medical Center, Durham, N.C.
R. Glenn Gaston, MD: ‡ OrthoCarolina Hand and Upper Extremity Department and Atrium Health Department of Orthopedic Surgery, Charlotte, N.C.
Grant M. Kleiber, MD: § Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, D.C.
Jason H. Ko, MD, MBA: ¶ Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.
Stephen J. Kovach, MD: ‖ Division of Plastic Surgery, Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, Pa.
Bryan J. Loeffler, MD: ‡ OrthoCarolina Hand and Upper Extremity Department and Atrium Health Department of Orthopedic Surgery, Charlotte, N.C.
Brendan J. MacKay, MD: ** Department of Orthopedic Surgery, Texas Tech University Health Science Center, Lubbock, Tex.
Benjamin K. Potter, MD: †† Uniformed Services University – Walter Reed Department of Surgery, Bethesda, Md.
Margaret S. Roubaud, MD: ‡‡ Department of Plastic and Reconstructive Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
Jason M. Souza, MD: §§ Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Ian L. Valerio, MD, MBA: From the * Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
Gregory A. Dumanian, MD: ¶ Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.

DOI: https://doi.org/10.1097/GOX.0000000000004928
Journal volume & issue: Vol. 11, no. 4
p. e4928

Abstract

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Amputations have been performed with few modifications since the dawn of surgery. Blood vessels are ligated, bones are shortened, and nerves are cut. In a percentage of people, this can result in severe neuropathic, residual limb, and phantom limb pain. Targeted muscle reinnervation is a surgical procedure initially conceived to optimize function for myoelectric prostheses in amputees. Recently, it has been adopted more widely by surgeons for the prevention and treatment of neuropathic pain. Perhaps as a function of its relatively recent development, many authors perform this operation differently, and there has been no overall agreement regarding the principles, indications, technical specifics, and postoperative management guidelines. This article is written as a consensus statement by surgeons focused on the treatment of neuropathic pain and those with extensive experience performing targeted muscle reinnervation. It is designed to serve as a roadmap and template for extremity surgeons to consider when performing targeted muscle reinnervation.

Published in Plastic and Reconstructive Surgery, Global Open

ISSN: 2169-7574 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://www.prsgo.com

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