Revision Targeted Muscle Reinnervation Improves Secondary Pain Insult in an Upper Extremity Amputee: A Case Report. Hand (N Y) 2021 Nov;16(6):NP15-NP18
Date
02/18/2021Pubmed ID
33593099Pubmed Central ID
PMC8647333DOI
10.1177/1558944721992467Scopus ID
2-s2.0-85100876712 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
Targeted muscle reinnervation (TMR) has been shown to improve phantom and neuropathic pain in both the acute and chronic amputee population. Through rerouting of major peripheral nerves into a newly denervated muscle, TMR harnesses the plasticity of the brain, helping to revert the sensory cortex back toward the preinsult state, effectively reducing pain. We highlight a unique case of an above-elbow amputee for sarcoma who was initially treated with successful transhumeral TMR. Following inadvertent nerve biopsy of a TMR coaptation site, his pain returned, and he was unable to don his prosthetic. Revision of his TMR to a more proximal level was performed, providing improved pain and function of the amputated arm. This is the first report to highlight the concept of secondary neuroplasticity and successful proximal TMR revision in the setting of multiple insults to the same extremity.
Author List
Rivedal DD, Guo M, Sanger J, Morgan AAuthor
David Rivedal MD Assistant Professor in the Plastic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AmputeesHumans
Male
Muscle, Skeletal
Phantom Limb
Upper Extremity
