Topic: Targeted Muscle Reinnervation and Peripheral Nerve Transfers

Peripheral nerve transfers have emerged as a powerful tool in the treatment of two seemingly disparate problems - the restoration of motor and sensory function after nerve injury, as well as in the mitigation of neuroma pain following amputation. Historically, the solutions for both problems were often inadequate. For the former, the crushing of nerve ends or reimplantation into muscle yielded often unpredictable results and high rates of post-amputation pain. Similarly, the evolution in the management of high or long gap nerve injuries has chartered a course from amputation to tendon transfers to nerve grafting; and while each retains some role, generally disappointing outcomes have driven the search for novel methods and techniques.

Accordingly, the last two decades have seen the re-introduction of peripheral nerve transfers as a new, exciting, and intellectually satisfying approach in these difficult clinical scenarios. Specifically, motor and sensory transfers have added a new dimension in the treatment of high and un-reconstructable nerve injuries. In a similar vein, targeted muscle reinnervation, a sensory to motor nerve transfer, has provided a novel solution for the treatment of neuroma and post-amputation pain. Overall, the innovations within this field over the past two decades have introduced a dizzying array of management options for once intractable problems, engendering an assortment of new techniques and applications - as well as controversy.

In this Special Issue of Plastic and Aesthetic Research, the editors aim to provide a comprehensive look at the current status of peripheral nerve transfers and targeted muscle reinnervation. Our goal is to provide the clinician with the best current evidence to help with decision making as these techniques become incorporated into everyday clinical practice: What are the indications? When are there better alternatives? What evidence exists for their use? Where is the field going? We welcome contributions from leading plastic and orthopedic surgery experts for this Special Issue in helping to answer these questions.

30 Apr 2023