Targeted Muscle Reinnervation and the Volar Forearm Filet Flap for Forequarter Amputation: Description of Operative Technique

• Main Authors: Marie T. Morris, MD, Christopher J. Dy, MD, MPH, Martin I. Boyer, MD, MSc, David M. Brogan, MD, MSc
• Format: Article
• Language: English
• Published: Elsevier 2020-09-01
• Series: Journal of Hand Surgery Global Online
• Subjects: Filet flap; Forequarter amputation; Targeted muscle reinnervation; Upper extremity amputation
• Online Access: http://www.sciencedirect.com/science/article/pii/S2589514120300529

Targeted muscle reinnervation after upper-extremity amputation has demonstrated improved outcomes with myoelectric prosthesis function and postoperative neuropathic pain. This technique has been established in the setting of shoulder disarticulation as well as transhumeral and transradial amputations, but a detailed technique of targeted muscle reinnervation with free tissue transfer from the volar forearm after forequarter amputation has not yet been described. Here, we describe a technique using a volar forearm filet flap to achieve simultaneously satisfactory soft tissue coverage after resection of a tumor from the chest wall and targeted muscle reinnervation of the brachial plexus.