Pedicled Serratus Anterior Flap as an Alternative Muscle Target for Targeted Muscle Reinnervation in Transhumeral Amputees

Lu, David; Myers, Harley; Bruscino-Raiola, Frank

doi:10.1016/j.jhsa.2019.07.008

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…10 Transhumeral/Above-the-Elbow TMR Fourteen original reports described donor nerve dissection and ideal motor nerve branch transfer recipient after transhumeral amputation (Table 4). [11][12][13][14][15][16][17][18][19][20][21][22][23][24] Some consistency in target muscle selection exists for mixed peripheral nerve TMR at this level (Fig. 4…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen original reports described donor nerve dissection and ideal motor nerve branch transfer recipient after transhumeral amputation (Table 4). 11–24 Some consistency in target muscle selection exists for mixed peripheral nerve TMR at this level (Fig. 4; Figure, Supplemental Digital Content 2, http://links.lww.com/SAP/A832).…”

Section: Resultsmentioning

confidence: 99%

“…Biceps brachii, short (medial) head (musculocutaneous) 11,12,[14][15][16][17][18][19][20][21]23 Brachialis (musculocutaneous) 13 Serratus slip (long thoracic) 21,23 Biceps brachii, long (lateral) head (musculocutaneous) 24 Hand closing; pronation 13 Ulnar nerve Brachialis (musculocutaneous) 11,12,16,17,19,24 Deltoid (anterior or posterior axillary) 15,20 Biceps brachii, short head (musculocutaneous) 13,21,23 Coracobrachialis (musculocutaneous) 14 Serratus slip (long thoracic) 21,23 Triceps, medial head (proximal radial) 12,22 Wrist rotation and flexion; hand closing 13 Distal radial nerve (to forearm extensors) Triceps, lateral head (proximal radial) [11][12][13][14][15][16]19,[21][22][23][24] Brachialis (musculocutaneous) 12,17,…”

Section: Median Nervementioning

confidence: 99%

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Targeted Muscle Reinnervation

et al. 2023

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Introduction/Background: Despite inspiring improvements in postamputation pain and prosthetic control, targeted muscle reinnervation (TMR) continues to be underused. With some consistency for recommended nerve transfers developing in the literature, it is necessary to systematize these techniques and simplify their incorporation into routine amputation and neuroma care. This systematic review explores the coaptations reported in the literature to date. Methods: A systematic review of the literature was performed to collect all reports describing nerve transfers in the upper extremity. The preference was directed toward original studies presenting surgical techniques and coaptations used in TMR. All target muscle options were presented for each nerve transfer in the upper extremity.Results: Twenty-one original studies describing TMR nerve transfers throughout the upper extremity met inclusion criteria. A comprehensive list of transfers reported for major peripheral nerves at each upper extremity amputation level was included in tables. Ideal nerve transfers were suggested based on convenience and frequency with which certain coaptations were reported. Conclusions: Increasingly frequent studies are published with convincing outcomes with TMR and numerous options for nerve transfers and target muscles. It is prudent to appraise these options to provide patients with optimal outcomes. Certain muscles are more consistently targeted and can serve as a baseline plan for the reconstructive surgeon interested in incorporating these techniques.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Median Nervementioning

confidence: 99%

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Targeted Muscle Reinnervation

et al. 2023

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“…Other reconstructive options could be a free innervated gracilis, latissimus dorsi, or serratus muscle, but we preferred the bulk and skin provided by a VRAM. A recent report by Lu et al suggested that the serratus muscle can serve as a source of multiple muscle targets in cases of proximal amputation without the need for microsurgery; unfortunately, this was not an option in this case (Lu et al, 2019). In addition, the rectus abdominus muscle provided multiple target nerves to coapt to the larger fascicles of the plexus.…”

Section: Discussionmentioning

confidence: 97%

Neurotized free VRAM used to create myoelectric signals in a muscle‐depleted area for targeted muscle reinnervation for intuitive prosthesis control: A case report

Huang

Chaudhry

et al. 2021

Microsurgery

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“…The latissimus provides soft tissue coverage and recipient motor nerves, thus addressing both the issues. Recently, Lu et al 8 described the use of the serratus anterior for soft tissue coverage and motor nerve recipients for TMR. Here, we describe the use of the latissimus dorsi flap for coverage of larger wounds in patients with transhumeral amputation, with the added benefit of providing 2 additional motor nerve recipients for TMR.…”

Section: Surgical Anatomymentioning

confidence: 99%