After limb loss, the road to recovery involves more than just healing from surgery. It also includes rebuilding function, managing pain, and adapting to a new prosthetic device.
To navigate these challenges successfully, you need an elite fellowship-trained amputee rehabilitation specialist like Dr. Lindsay E. Janes.
In her Chicago, IL, practice, Dr. Janes offers a highly specialized procedure, Targeted Muscle Reinnervation (TMR), that helps with all three of these things.
What Is Targeted Muscle Reinnervation?
Targeted Muscle Reinnervation is a microsurgical procedure in which Dr. Janes reroutes severed peripheral nerves from an amputation to nearby, otherwise unused muscles.
These target muscle sites serve as biological “endpoints” for regenerating nerves. Instead of forming painful neuromas, the nerves can reinnervate muscle tissue and send more organized signals.
Originally developed to enhance prosthetic function, TMR has since been demonstrated to alleviate neuroma and phantom limb pain.
In addition to helping patients feel more in control of their prosthetic limb, the procedure also provides an active way to manage nerve-related pain symptoms.
How TMR Enhances Prosthetic Control
When a nerve is connected to a new muscle, that muscle begins to receive signals once controlled by the missing limb. These signals can be detected by surface electrodes and interpreted by a myoelectric prosthesis.
As a result, patients can perform intuitive movements such as opening and closing a hand or rotating a wrist using their natural brain impulses.
This control is often more precise and responsive than traditional prosthetic systems that rely on less specific muscle groups. With TMR, patients can regain a level of coordination and function that feels more lifelike.
Who Is a Candidate for Upper Extremity TMR?
TMR is appropriate for patients with upper limb amputations who experience phantom pain, neuroma-related discomfort, or difficulty using a prosthesis.
Or, TMR can be performed at the time of amputation (immediate TMR).
It’s not for spinal cord or brachial plexus injuries.
Patients must be generally healthy, which is a requirement for any surgery.
What to Expect During and After Surgery
TMR is performed under general anesthesia. Using a microscope and specialized instruments, Dr. Janes carefully transfers the nerve endings to targeted muscle sites, typically selecting muscles that are no longer needed for other functions. It’s highly precise work for which she draws upon her extensive microsurgical training and experience in advanced nerve coaptation techniques.
Following surgery, you’ll participate in a rehabilitation program that includes physical therapy and training with your prosthetic team. Over time, your body learns to send signals through the newly formed nerve pathways, thereby improving both comfort and control.
If you have TMR to manage existing nerve pain, you can resume work in as little as two weeks. If you have TMR immediately after amputation, you can start prosthetic fitting in about one month to six weeks.
Amputee Rehabilitation Consultations in Chicago, IL
Dr. Janes evaluates each case individually and collaborates closely with prosthetists, physical therapists, and referring physicians to design a personalized care plan that supports the patient’s long-term recovery and optimal function.
To learn more about Targeted Muscle Reinnervation in Chicago or to refer a patient for consultation, contact Dr. Lindsay E. Janes at (312) 695-6022.