Abstract
Hand loss is a catastrophic event that generates significant demands for orthopedics
and prosthetics. In the course of history, prostheses evolved from passive esthetic
replacements to sophisticated robotic hands. Yet, their actuation and particularly,
their capacity to provide patients with sensations, remain an unsolved problem. Sensations
associated with the hand, such as touch, pain, pressure and temperature detection
are very important, since they enable humans to gather information from the environment.
Recently, through a synergistic multidisciplinary effort, medical doctors and engineers
have attempted to address these issues by developing bionic limbs. The aim of the
bionic hands is to replace the amputated hands while restoring sensation and reintroducing
hand-motor control. Recently, several different approaches have been made to interface
this sophisticated prosthesis with residual neuro-muscular structures. Different types
of implants, such as intramuscular, epineural and intraneural, each have their own
complementary advantages and disadvantages, which are discussed in this paper. After
initial trials with percutaneous leads, present research is aimed at making long-term
implantable electrodes that give rich, natural feedback and allow for effortless control.
Finally, a pivotal part in the development of this technology is the surgical technique
which will be described in this paper. The surgeons’ insights into this procedure
are given. These kinds of prostheses compared with the classic one, hold a promise
of dramatic health and quality of life increase, together with the decrease the rejection
rate.
Keywords
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Article info
Publication history
Published online: October 21, 2019
Footnotes
This paper is part of a Supplement supported by the European Federation of Societies of Microsurgery (EFSM) and the Serbian Society for Reconstructive Microsurgery (SSRM).
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Copyright
© 2019 Elsevier Ltd. All rights reserved.
