{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T02:34:15Z","timestamp":1765506855991,"version":"3.37.3"},"reference-count":43,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund Die obere Extremit\u00e4t und insbesondere die Hand sind f\u00fcr die\n                    Interaktion des Menschen mit seiner Umwelt von entscheidender Bedeutung \u2013\n                    schwere Verletzungen oder Amputationen gehen daher mit einem erheblichen\n                    Funktionsverlust einher und beeintr\u00e4chtigen die Lebensqualit\u00e4t der Patienten\n                    sehr. Wenn biologische Rekonstruktionsversuche nicht zu einem ausreichenden\n                    Erfolg f\u00fchren oder nicht m\u00f6glich sind, kommt der bionischen Rekonstruktion eine\n                    Schl\u00fcsselrolle in der Versorgung dieser Patienten zu. Konventionelle\n                    myoelektrische Prothesen werden \u00fcber zwei Signale gesteuert, die \u00fcber\n                    Oberfl\u00e4chenelektroden im Bereich der Stumpfmuskulatur abgeleitet werden.\n                    Insbesondere bei hohen Amputationen ist die Prothesensteuerung dann nur sehr\n                    eingeschr\u00e4nkt und umst\u00e4ndlich m\u00f6glich. Die Operationsmethode der Targeted Muscle\n                    Reinnervation (TMR) bietet hier einen innovativen L\u00f6sungsansatz: Die gro\u00dfen\n                    Armnerven, die durch Amputation ihre Zielorgane verloren haben, werden auf neue\n                    Zielmuskeln im Bereich des Amputationsstumpfes transferiert. Dadurch k\u00f6nnen\n                    kognitive Steuersignale etabliert werden, welche eine deutlich verbesserte\n                    Prothesensteuerung erm\u00f6glichen.<\/jats:p><jats:p>\n          Patienten\/Material und Methoden Es erfolgte eine selektive\n                    Literaturrecherche zum Thema TMR und bionische Rekonstruktion mit Aufarbeitung\n                    und Diskussion relevanter Arbeiten, unter Ber\u00fccksichtigung der klinischen\n                    Erfahrungen unserer Forschungsgruppe. Zus\u00e4tzlich wird ein klinischer\n                    Patientenfall vorgestellt.<\/jats:p><jats:p>\n          Ergebnisse Die bionische Rekonstruktion in Kombination mit TMR erm\u00f6glicht\n                    eine intuitive Prothesensteuerung mit simultaner Bewegung verschiedener\n                    prothetischer Freiheitsgrade und bietet zudem einen neuen Ansatz in der Therapie\n                    von Neurom- und Phantomschmerzen. Langfristiger Erfolg erfordert ein hohes Ma\u00df\n                    an Patientencompliance und intensives Signaltraining w\u00e4hrend der prothetischen\n                    Rehabilitationsphase. Trotz technologischer Fortschritte bestehen weiterhin\n                    Herausforderungen, insbesondere hinsichtlich der Signal\u00fcberleitung und der\n                    sensiblen Integration bionischer Prothesen.<\/jats:p><jats:p>\n          Schlussfolgerung Die Operationstechnik der TMR stellt einen bedeutenden\n                    Fortschritt der prothetischen Versorgung von Amputierten dar. Durch selektive\n                    Nerventransfers zur Signalmultiplikation und -amplifikation erm\u00f6glicht sie, das\n                    Potential myoelektrischer Prothesen weiter auszusch\u00f6pfen und die Therapie dieser\n                    speziellen Patientengruppe zu verbessern. Entwicklungen im Bereich der externen\n                    Prothesenkomponenten, Verbesserungen der skelettalen Anbindung durch\n                    Osseointegration und fl\u00fcssigere Signal\u00fcbertragung durch drahtlose, vollst\u00e4ndig\n                    implantierte Elektrodensysteme werden sowohl hinsichtlich der\n                    Bewegungspr\u00e4zision, als auch des Embodiments deutliche Fortschritte in der\n                    bionischen Rekonstruktion erm\u00f6glichen.<\/jats:p>","DOI":"10.1055\/a-2260-9842","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:32:06Z","timestamp":1709166726000},"page":"84-92","source":"Crossref","is-referenced-by-count":1,"title":["Prothetische Versorgungskonzepte nach Majoramputation der oberen\n                    Extremit\u00e4t \u2013 eine \u00dcbersicht gegenw\u00e4rtiger M\u00f6glichkeiten"],"prefix":"10.1055","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8463-0397","authenticated-orcid":false,"given":"Leopold","family":"Harnoncourt","sequence":"additional","affiliation":[{"name":"Klinisches Labor f\u00fcr Bionische Extremit\u00e4tenrekonstruktion,\n                    Universit\u00e4tsklinik f\u00fcr Plastische, Rekonstruktive und \u00c4sthetische Chirurgie,\n                    Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemens","family":"Gstoettner","sequence":"additional","affiliation":[{"name":"Klinisches Labor f\u00fcr Bionische Extremit\u00e4tenrekonstruktion,\n                    Universit\u00e4tsklinik f\u00fcr Plastische, Rekonstruktive und \u00c4sthetische Chirurgie,\n                    Medizinische Universit\u00e4t Wien, Wien, Austria"},{"name":"Universit\u00e4tsklinik f\u00fcr Plastische, Rekonstruktive und \u00c4sthetische\n                    Chirurgie, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregor","family":"Laengle","sequence":"additional","affiliation":[{"name":"Klinisches Labor f\u00fcr Bionische Extremit\u00e4tenrekonstruktion,\n                    Universit\u00e4tsklinik f\u00fcr Plastische, Rekonstruktive und \u00c4sthetische Chirurgie,\n                    Medizinische Universit\u00e4t Wien, Wien, Austria"},{"name":"Universit\u00e4tsklinik f\u00fcr Plastische, Rekonstruktive und \u00c4sthetische\n                    Chirurgie, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Boesendorfer","sequence":"additional","affiliation":[{"name":"Klinisches Labor f\u00fcr Bionische Extremit\u00e4tenrekonstruktion,\n                    Universit\u00e4tsklinik f\u00fcr Plastische, Rekonstruktive und \u00c4sthetische Chirurgie,\n                    Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oskar","family":"Aszmann","sequence":"additional","affiliation":[{"name":"Klinisches Labor f\u00fcr Bionische Extremit\u00e4tenrekonstruktion,\n                    Universit\u00e4tsklinik f\u00fcr Plastische, Rekonstruktive und \u00c4sthetische Chirurgie,\n                    Medizinische Universit\u00e4t Wien, Wien, Austria"},{"name":"Universit\u00e4tsklinik f\u00fcr Plastische, Rekonstruktive und \u00c4sthetische\n                    Chirurgie, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.pmr.2013.09.010","article-title":"Emotional adaptation to limb loss","volume":"25","author":"H P Belon","year":"2014","journal-title":"Phys Med Rehabil Clin N 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