Vienna University. Austria: The leading medical journal, "The Lancet", has just published a
study by Oskar Aszmann. In this study, Aszmann describes the bionic
reconstruction technique he has developed at the MedUni Vienna. Complex
neuromuscular procedures are performed to create a biotechnology
interface that gives patients mechatronic hand functions. Patients can
subsequently get on with their lives with two hands again.
The
brachial plexus, the bundle of nerves running down the arm, controls
human arm and hand function and is supplied by five "roots" from the
spinal cord. Serious accidents can tear these roots out of the spinal
cord, destroying the hand's function and sensation. In most cases,
conventional surgical techniques are unable to help victims of such
trauma.
The bionic reconstruction method on three patients described in the
Lancet study, however, changes this. Oskar Aszmann, Head of the
Christian Doppler Laboratory for the Restoration of Limb Functions at
the MedUni Vienna's Department of Plastic and Reconstructive Surgery,
explains what the method involves: "Bionic reconstruction is a holistic
concept that covers more than just surgical technique. It involves
complex neuromuscular activities that make an interactive interface
possible between humans and machines. To begin with, a precise
exploration needs to be carried out of the global hand/arm function and
the remaining nerve branches. These are then biopsied during a surgical
procedure and their function checked. If they respond positively, a
piece of muscle is removed from the thigh and transplanted into the
forearm. The muscle acts as a signal amplifier for the remaining
nerves." Aszmann continues: "Muscle contraction generates electrical
signals of adequate strength. These myosignals are used to control the
new, mechatronic hand."
But before the new hand is attached, the patient first learns how to
use the prosthesis via an electronic interface. This is important, as
the patient's brain will have forgotten how to use the hand since in
some cases it may already have been non-functioning for a number of
years. Once this technological neuro-rehabilitation is complete, the
non-functioning hand is amputated and ultimately replaced with the hand
prosthesis. The patient is therefore given back a voluntarily
controllable, functioning hand.
Tremendous additional benefit for patients
"For the
patients, it is always a tremendous additional benefit to continue their
lives with two hands. Patients are able to get back to work, and their
relationships and private lives improve considerably." Another important
point is the subject of pain. "Patients often experience severe phantom
pain. This pain disappears with the bionic reconstructions, since the
phantom is being replaced by the restored functionality of the hand."
Vienna leads the world
Aszmann's bionic reconstruction
concept was first tried out in 2009. Since then, Aszmann and his team -
the MedUni Vienna is the world's only facility to use this technology -
have been able to restore the physical integrity of numerous patients
and help them to enjoy a new quality of life and vitality.
Bionic reconstruction is not body enhancement
Aszmann is
keen to point out that bionic reconstruction is in no way a form of body
enhancement. "We are seeking to restore defects, not make healthy
people even better." Aszmann therefore has reservations about other
types of bionic technology: In a further study, recently published in
the specialist journal "Science Translational Medicine", Aszmann and
Dario Farina from the University of Göttingen are critical of the
benefits of implanted electrodes to control hand prostheses. The two
authors conclude that the majority of the technologies currently being
used are causing patients much more harm than good, and that they are of
dubious ethical merit.
Service: Lancet
„Bionic
reconstruction to restore hand function after brachial plexus injury: a
case series of three patients Bionic reconstruction to restore hand
function after brachial plexus injury: a case series of three patients.“
Oskar C Aszmann, Aidan D Roche, Stefan Salminger, Tatjana
Paternostro-Sluga, Malvina Herceg, Agnes Sturma, Christian Hofer, Dario
Farina. February 25, 2015. dx.doi.org/10.1016/S0140-6736(14)61776-1.
» Video - Interview with Oskar Aszmann