SHOULDER DISARTICULATION FITTING WITH 6 INDEPENDENTLY CONTROLLED MOTORS AFTER TARGETED HYPER-REINNERVATION NERVE TRANSFER SURGERY

Abstract

In 2002, targeted hyper-reinnervation nerve transfer surgery was performed unilaterally on a bilateral shoulder disarticulation amputee. The goal of this surgery was to create additional sites using the remaining unused brachial plexus nerves to allow simultaneous control of multiple movements using more natural control schemes [1,2,3]. As a result of the nerve transfer procedure, 4 new myoelectric control sites were created on the left pectoralis muscle. Subsequent prosthetic fitting found that the user was able to operate the elbow and hand in a coordinated fashion using three electrodes. Various outcome measurements showed an improvement in prosthetic function. However, with the increase in the number of input signals, a goal was set to build a prosthesis with the maximum number of controlled motors available. Six motorized components were identified: three were commercially available in the USA, one was commercially available in other countries and two were a research prototype.