Upper limb amputation is a universally devastating injury that results in substantial
loss of function. Myoelectric prostheses represent a new generation of battery-powered
programmable prostheses controlled by EMG signals. The aim of upper limb targeted
muscle reinnervation (TMR) is to enhance the control of a myoelectric prosthesis by
improving the number and quality of EMG signals that can be used to control prosthetic
elbow, wrist, and hand movements. Current TMR techniques rely on preservation of parts
of biceps and triceps to be used as reinnervated muscle targets. However, a subset
of amputations exists in which the proximity or mechanism of injury results in loss
of these local muscle targets, making these techniques less suitable. Alternative
muscles beyond the zone of injury must be sought and imported as targets for residual
nerves. Through its neurovascular anatomy and physical structure, the serratus anterior
offers multiple potential targets in close vicinity to the upper limb, making the
creation of additional signals through a single flap achievable in this challenging
scenario. We present our technique using a pedicled serratus anterior muscle flap
as an alternative muscle target in transhumeral amputees undergoing TMR.
Key words
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Article info
Publication history
Published online: September 17, 2019
Accepted:
July 25,
2019
Received:
January 11,
2019
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
