New surgeries allow upper extremity amputee patients optimal function

Charlotte-based hand surgeons performing revolutionary Targeted Muscle Reinnervation and other procedures

CHARLOTTE, N.C., Sept. 18, 2017 (GLOBE NEWSWIRE) -- Two Charlotte, N.C.-based orthopedic hand surgeons are pioneering new amputee surgeries that are offering patients unparalleled use of their upper extremities. OrthoCarolina hand surgeons Glenn Gaston and Bryan Loeffler are performing and developing multiple new surgical techniques for upper extremity amputees, including Targeted Muscle Reinnervation (TMR), which transplants nerves and allows them to reinnervate, or grow into, another muscle. TMR surgery enables nerve signals that have been transferred into a new muscle to control prostheses as a normal human arm would, using nerve impulses sent directly from the brain.

One of Dr. Gaston and Loeffler’s most recent and notable TMR patients is 32-year old mother of three Tiffany Johnson who lost her right arm when she was bitten by a shark while snorkeling off the coast of the Bahamas in June. The surgeons amputated Johnson’s arm just below the elbow joint. With badly damaged muscles and skin, the surgeons’ challenge was to keep the amputation below the elbow to ensure functional and sustained use of the limb. They transferred nerves that controlled the hand from the severed limb to another part of the arm, reinserting those nerves into another muscle. In their new location Johnson’s nerves can function as they would have previously. She is in the process of learning to use her new myoelectric hand, which is controlled by signals from her brain.

“Reassigning nerves to another part of the limb allows a patient easier control of their prosthesis and can also significantly reduce the phantom pain often felt by amputees,” said Dr. Gaston. “Even when a limb is gone, nerves are still available for the body to use.”

Drs. Loeffler and Gaston are developing other innovative forms of TMR by adapting the principles to other parts of the body including the forearms and legs. They also completed the first surgery for the prosthetic hand with individual finger control in 2016.

Beyond TMR, the doctors are leading experts in other advanced nerve reconstruction surgeries for adults and children with spinal cord injuries as well as brachial plexus injuries. They lead the the OrthoCarolina Reconstructive Center for Lost Limbs, a multidisciplinary clinic intended to help upper extremity amputees by offering patients the latest surgical innovations and technology to help them restore maximum limb performance and live life to the fullest. Cutting-edge techniques and surgeries include targeted muscle reinnervation, the STARFISH procedure (developed by the OrthoCarolina Hand Center), and flexion osteotomies to improve prosthetic fit and control.  The Clinic coordinates with local and regional prosthetists and utilizes the most advanced myoelectric prostheses available.

“By coming to the clinic individuals who have amputations can meet with multiple healthcare providers and address variety of daily challenges that affect their lives, including general health and wellness, mobility, independence and more,“ said Dr. Loeffler. “It is also a chance for patients to meet others who have their same injuries or who have had similar surgeries, which goes a long way in dealing with the emotional part of their injury.”

Drs. Gaston and Loeffler have recently received awards from the American Academy of Orthopaedic Surgeons (AAOS) and have spoken at numerous international meetings about their work in the field of upper extremity reconstruction for amputees. Read more at

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Logan Stewart