Chirurgie (Heidelb). 2026 May 6. doi: 10.1007/s00104-026-02496-z. Online ahead of print.
ABSTRACT
Amputation medicine has evolved into a specialized, technology-driven discipline. With increasing global amputation rates, advanced surgical techniques, innovative prosthetic solutions and digital rehabilitation are gaining importance. Transcutaneous osseointegrated prosthetic systems (TOPS) can improve mobility, proprioception and quality of life but carry risks such as stomal infections or periprosthetic fractures. Neuroreconstructive procedures including targeted muscle reinnervation (TMR), targeted sensory reinnervation (TSR), regenerative peripheral nerve interface (RPNI), agonist-antagonist myoneural interface (AMI) and nerve caps enable intuitive prosthesis control and reduce neuroma and phantom pain. Preoperative diagnostics and careful patient selection are essential. Guidelines emphasize structured rehabilitation and interdisciplinary follow-up. Virtual reality (VR) and extended reality (XR) procedures extend the treatment spectrum and support motor function and phantom pain reduction. Overall, this results in an integrated treatment concept with clear functional and psychosocial advantages.
PMID:42089978 | DOI:10.1007/s00104-026-02496-z