Symptomatic neuroma after major extremity amputation is a challenging clinical problem for which there are many described treatment options. Neuroma excision and implantation into the medullary canal of long bones offers durability and insulation, and minimizes chronic pain. Another challenge in amputees is impaired function and an ongoing need for accessible and functional prostheses that are “bidirectional,” in that they provide both fine motor control and sensory feedback. Drawing on clinical experience with neuroma implantation into the medullary canal of long bones, the authors propose a novel neural interface whereby a terminal nerve end is redirected into the medullary canal of a nearby long bone and interfaced with an electrode array. The osseointegrated neural interface aims to exploit electrical signals from peripheral nerves to control advanced prosthetic devices for amputees. The purpose of this article is to present 2 clinical cases of nerve translocation into bone that serve as the clinical foundation of the osseointegrated neural interface as an innovative interface for prosthetic control.
From the *Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wis.;
†Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.;
‡Department of Biomedical Engineering, College of Engineering, University of Wisconsin – Madison, Madison, Wis.;
§Department of Biomedical Engineering, University of Minnesota Twin Cities, Minneapolis, Minn.
Published online 21 May 2018.
Received for publication February 5, 2018; accepted March 26, 2018.
Supported by the Defense Advanced Research Projects Agency (DARPA) Biological Hand Proprioception and Touch Interfaces program under the auspices of Dr. Doug Weber through the DARPA Contracts Management Office Grant/Contract No. HR0011-15-2-0008.
Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.
Samuel O. Poore, MD, PhD, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, E-mail: firstname.lastname@example.org
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