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In one person with unilateral below-elbow amputation, titanium implants were placed intramedullary in the radius and ulna bones, and electromuscular constructs were created surgically by transferring the severed nerves to free muscle grafts. The native muscles, free muscle grafts, and ulnar nerve were implanted with electrodes. Percutaneous extensions from the titanium implants provided direct skeletal attachment and bidirectional communication between the implanted electrodes and a prosthetic hand. Operation of the bionic hand in daily life resulted in improved prosthetic function, reduced postamputation, and increased quality of life. Sensations elicited via direct neural stimulation were consistently perceived on the phantom hand throughout the study. To date, the patient continues using the prosthesis in daily life. The functionality of conventional artificial limbs is hindered by discomfort and limited and unreliable control. Neuromusculoskeletal interfaces can overcome these hurdles and provide the means for the everyday use of a prosthesis with reliable neural control fixated into the skeleton.<\/jats:p>","DOI":"10.1126\/scirobotics.adf7360","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T17:59:11Z","timestamp":1697047151000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark","source":"Crossref","is-referenced-by-count":87,"title":["A highly integrated bionic hand with neural control and feedback for use in daily life"],"prefix":"10.1126","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6084-3865","authenticated-orcid":true,"given":"Max","family":"Ortiz-Catalan","sequence":"first","affiliation":[{"name":"Center for Bionics and Pain Research, M\u00f6lndal, Sweden."},{"name":"Bionics Institute, Melbourne, Australia."},{"name":"Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden."},{"name":"University of 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