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Innovations in Prosthetic Interfaces for the Upper Extremity

Kung, Theodore A. M.D.; Bueno, Reuben A. M.D.; Alkhalefah, Ghadah K. M.B.B.S.; Langhals, Nicholas B. Ph.D.; Urbanchek, Melanie G. Ph.D.; Cederna, Paul S. M.D.

Plastic and Reconstructive Surgery: December 2013 - Volume 132 - Issue 6 - p 1515–1523
doi: 10.1097/PRS.0b013e3182a97e5f
Hand/Peripheral Nerve: Special Topic

Summary: Advancements in modern robotic technology have led to the development of highly sophisticated upper extremity prosthetic limbs. High-fidelity volitional control of these devices is dependent on the critical interface between the patient and the mechanical prosthesis. Recent innovations in prosthetic interfaces have focused on several control strategies. Targeted muscle reinnervation is currently the most immediately applicable prosthetic control strategy and is particularly indicated in proximal upper extremity amputations. Investigation into various brain interfaces has allowed acquisition of neuroelectric signals directly or indirectly from the central nervous system for prosthetic control. Peripheral nerve interfaces permit signal transduction from both motor and sensory nerves with a higher degree of selectivity. This article reviews the current developments in each of these interface systems and discusses the potential of these approaches to facilitate motor control and sensory feedback in upper extremity neuroprosthetic devices.

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Ann Arbor, Mich.; and Springfield, Ill.

From the Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan Health System; and the Department of Surgery, Division of Plastic Surgery, Southern Illinois University.

Received for publication February 26, 2013; accepted July 24, 2013.

Disclosure: None of the authors has a financial interest in any of the products or devices mentioned in this article. This project did not require any sources of funding.

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Paul S. Cederna, M.D., Section of Plastic Surgery, 2130 Taubman Center, SPC 5340, 1500 East Medical Center Drive, Ann Arbor, Mich. 48109,

©2013American Society of Plastic Surgeons