Targeted muscle reinnervation in quadruple amputees: self-reported outcomes

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Emma-Leigh Rudduck
Frank Bruscino-Raiola
Margaret Angliss
Steven J Gray
David Lee Gow
Abby Hutchinson


Targeted muscle reinnervation, neuropathic pain,, phantom limb pain


Targeted muscle reinnervation (TMR) reduces pain and physical and psychological disabilities in amputees. We present the first two cases reported globally of quadruple amputees that underwent acute TMR. Each patient completed our novel ‘The Alfred Hospital Osteointegration Survey’ (TAHOS) for each limb at six, 12 and 24 months post amputation which evaluated aspects of prosthesis wear, neuroma-related residual limb pain (RLP), phantom limb pain (PLP) and overall function. Our findings that TMR reduced or eliminated RLP and PLP by 12 months and clinically improved prosthetic function in both quadruple amputees reflects the current literature for single and multiple limb amputees.


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