Elbow joint salvage in pediatric traumatic amputation with targeted muscle reinnervation, external tissue expansion, and free muscle flap – A case report

Abstract

The authors report targeted muscle reinnervation (TMR) in an 11-year-old male who sustained a trans-radial amputation of the right upper extremity in an ATV accident. A combination of targeted muscle reinnervation, external tissue expansion, and free muscle transfer allowed us to preserve elbow function, prevent neuroma formation, and allow for the future use of a myoelectric prosthetic. The use of TMR in pediatrics leverages the enhanced cortical plasticity of younger patients to improve outcomes and quality of life following traumatic injury, limiting the otherwise significant financial and psychosocial impact of amputation. This report offers the first account of TMR performed on a pediatric patient with no neuroma formation or phantom limb pain. • TMR redirects severed nerves to muscular targets. • This prevents neuroma and generates neural control for myoelectric prosthetic use. • TMR aided in the salvage of the dominant elbow joint of an 11-year-old male. • This is the first report of TMR in a pediatric upper extremity traumatic amputation.