Table 2.
Primary TNI in the setting of acute traumatic amputation
| Patient | Acute mechanism | Formal amputation level | Specific TNI (nerve to muscle motor point) | Number of nerve transfers | Followup (months) | Neuroma pain after TNI | Phantom pain after TNI | Comments |
|---|---|---|---|---|---|---|---|---|
| 1 | All-terrain vehicle rollover | Shoulder disarticulation | MeN to pectoralis major, RN to teres major, UN to serratus | 3 | 11 | No | Yes | Palpable, painless ulnar neuroma |
| 2 | Caught in conveyor belt | Shoulder disarticulation | MeN to pectoralis major, RN to latissimus dorsi, UN to pectoralis minor | 3 | 18 | Possible | Yes | Hypersensitivity at amputation site and phantom limb pain; neuroma possible |
| 3 | Crush injury | Short transhumeral | McN to pectoralis major, MeN to biceps, RN to triceps, UN to latissimus dorsi | 4 | 57 | No | No | |
| 4 | Caught in conveyor belt | Short transhumeral | McN to medial biceps, MeN to lateral biceps, RN to triceps, UN to latissimus dorsi | 4 | 16 | No | No | |
| 5 | Caught in conveyor belt | Short transhumeral | MeN to upper pectoralis major, RN to serratus anterior, UN to lower pectoralis major | 3 | 60 | No | Yes | |
| 6 | Motorcycle crash | Short transhumeral | MeN to pectoralis major, UN to teres major, RN to latissimus dorsi | 3 | 23 | No | Yes | |
| 7 | Hit by train | Long transhumeral | MeN to medial biceps, RN to lateral triceps, UN to brachialis | 3 | 14 | No | No | |
| 8 | Motor vehicle crash | Long transhumeral | McN to lateral biceps, MeN to medial biceps, RN to lateral triceps, UN to brachialis | 4 | 9 | No | No | |
| 9 | Motor vehicle crash | Long transhumeral | MeN to biceps, RN to brachialis | 2 | 8 | No | No | Phantom sensation but no phantom pain |
| 10 | Motor vehicle crash | Elbow disarticulation | MeN to medial biceps, UN to triceps | 2 | 29 | No | Yes | |
| 11 | Caught in conveyor belt | Above elbow | MeN to pectoralis major, formal UN to TDN transfer | 1 | 21 | No | Yes | |
| 12 | Motorcycle crash | Knee disarticulation | TN to medial hamstring, PN to lateral hamstring | 2 | 12 | No | No |
All primary TNI procedures were performed within several days of injury and formal surgical amputation; TNI = targeted nerve implantation; MeN= median nerve; RN = radial nerve; UN = ulnar nerve; McN = musculocutaneous nerve; TDN = thoracodorsal nerve; TN = tibial nerve; PN = peroneal nerve.