Nerve, muscle preservation could improve myoelectric prostheses

Research and financial backing have improved myoelectric prostheses, but user success largely depends on surgical procedures and outcomes, new findings from the Journal of the American Academy of Orthopaedic Surgeons suggest.

Many users experience difficulty achieving fine motor control or full rotation of a myoelectric hand, and the socket interface can interfere with the function of a residual joint, such as the elbow. Accurately sending brain signals through the muscles and peripheral nerves of the arm and hands has also been a challenge.

Solutions to these issues might be found in combining recent advancements in prosthetic devices with breakthroughs in maintaining nerve and muscle function in badly damaged limbs, according to research.

“Orthopaedic surgeons who do peripheral nerve surgery will be part of the team that puts these devices into patients, but perhaps more relevant than that will be the way we treat severe near amputations or complete amputations differently,” study author Douglas T. Hutchinson, MD, associate professor of orthopaedics at the University of Utah Medical School, chief of hand surgery at Primary Children’s Medical Center, the Veterans Affairs Medical Center, Shriners Intermountain Hospital, stated in a news release. “In an amputation surgery, we will need to preserve muscles and nerves even more than we already do to make this type of later reconstruction more successful.”

Perfection of nerve utilization could also aid other conditions including chronic nerve pain, cerebral palsy and brachial plexus injuries.

The 2014 federal budget for prosthetic research is $2.5 billion, and the U.S. Department of Defense Advanced Research Project has invested more than $150 million into its Revolutionizing Prosthetics Program, according to the release.

The program has already created several advanced upper extremity prostheses with full motor and sensory function that benefit injured veterans but these advanced devices are not yet widely used in civilians.

Hutchinson D. J Am AcadOrthop Surg. 2014:doi: 10.5435/JAAOS-22-06-3.


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