TMRpni: Combining Two Peripheral Nerve Management Techniques
Summary:. Amputee patients suffer high rates of chronic neuropathic pain, residual limb dysfunction, and disability. Recently, targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) are 2 techniques that have been advocated for such patients, given their ability to ma...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2020-10-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003132 |
| _version_ | 1818924598386753536 |
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| author | David E. Kurlander, MD Corinne Wee, MD Kyle J. Chepla, MD Kyle D. Lineberry, MD Tobias C. Long, MD Joshua A. Gillis, MD, FRCSC Ian L. Valerio, MD, MS, MBA, FACS Joseph S. Khouri, MD |
| author_facet | David E. Kurlander, MD Corinne Wee, MD Kyle J. Chepla, MD Kyle D. Lineberry, MD Tobias C. Long, MD Joshua A. Gillis, MD, FRCSC Ian L. Valerio, MD, MS, MBA, FACS Joseph S. Khouri, MD |
| author_sort | David E. Kurlander, MD |
| collection | DOAJ |
| description | Summary:. Amputee patients suffer high rates of chronic neuropathic pain, residual limb dysfunction, and disability. Recently, targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) are 2 techniques that have been advocated for such patients, given their ability to maximize intuitive prosthetic function while also minimizing neuropathic pain, such as residual and phantom limb pain. However, there remains room to further improve outcomes for our residual limb patients and patients suffering from symptomatic end neuromas. “TMRpni” is a nerve management technique that leverages beneficial elements described for both TMR and RPNI. TMRpni involves coaptation of a sensory or mixed sensory/motor nerve to a nearby motor nerve branch (ie, a nerve transfer), as performed in traditional TMR surgeries. Additionally, the typically mismatched nerve coaptation is wrapped with an autologous free muscle graft that is akin to an RPNI. The authors herein describe the “TMRpni” technique and illustrate a case where this technique was employed. |
| first_indexed | 2024-12-20T02:27:52Z |
| format | Article |
| id | doaj.art-5ef5c3a692eb45ee87369089e2557823 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-20T02:27:52Z |
| publishDate | 2020-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-5ef5c3a692eb45ee87369089e25578232022-12-21T19:56:39ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742020-10-01810e313210.1097/GOX.0000000000003132202010000-00025TMRpni: Combining Two Peripheral Nerve Management TechniquesDavid E. Kurlander, MD0Corinne Wee, MD1Kyle J. Chepla, MD2Kyle D. Lineberry, MD3Tobias C. Long, MD4Joshua A. Gillis, MD, FRCSC5Ian L. Valerio, MD, MS, MBA, FACS6Joseph S. Khouri, MD7From the * Department of Plastic Surgery, Case Western Reserve University, Cleveland, OhioFrom the * Department of Plastic Surgery, Case Western Reserve University, Cleveland, OhioFrom the * Department of Plastic Surgery, Case Western Reserve University, Cleveland, OhioFrom the * Department of Plastic Surgery, Case Western Reserve University, Cleveland, OhioFrom the * Department of Plastic Surgery, Case Western Reserve University, Cleveland, Ohio§ Department of Plastic Surgery, Western University, London, Ontario, Canada¶ Department of Plastic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Mass.From the * Department of Plastic Surgery, Case Western Reserve University, Cleveland, OhioSummary:. Amputee patients suffer high rates of chronic neuropathic pain, residual limb dysfunction, and disability. Recently, targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) are 2 techniques that have been advocated for such patients, given their ability to maximize intuitive prosthetic function while also minimizing neuropathic pain, such as residual and phantom limb pain. However, there remains room to further improve outcomes for our residual limb patients and patients suffering from symptomatic end neuromas. “TMRpni” is a nerve management technique that leverages beneficial elements described for both TMR and RPNI. TMRpni involves coaptation of a sensory or mixed sensory/motor nerve to a nearby motor nerve branch (ie, a nerve transfer), as performed in traditional TMR surgeries. Additionally, the typically mismatched nerve coaptation is wrapped with an autologous free muscle graft that is akin to an RPNI. The authors herein describe the “TMRpni” technique and illustrate a case where this technique was employed.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003132 |
| spellingShingle | David E. Kurlander, MD Corinne Wee, MD Kyle J. Chepla, MD Kyle D. Lineberry, MD Tobias C. Long, MD Joshua A. Gillis, MD, FRCSC Ian L. Valerio, MD, MS, MBA, FACS Joseph S. Khouri, MD TMRpni: Combining Two Peripheral Nerve Management Techniques Plastic and Reconstructive Surgery, Global Open |
| title | TMRpni: Combining Two Peripheral Nerve Management Techniques |
| title_full | TMRpni: Combining Two Peripheral Nerve Management Techniques |
| title_fullStr | TMRpni: Combining Two Peripheral Nerve Management Techniques |
| title_full_unstemmed | TMRpni: Combining Two Peripheral Nerve Management Techniques |
| title_short | TMRpni: Combining Two Peripheral Nerve Management Techniques |
| title_sort | tmrpni combining two peripheral nerve management techniques |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003132 |
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