Targeted Muscle Reinnervation for Treatment of Symptomatic Neuroma

Targeted muscle reinnervation (TMR) is a nerve transfer that was originally devised in 2002 to signal myoelectric upper extremity prostheses. Over time, it became apparent that the local nerve pain and phantom limb pain in amputees improved with TMR, and this was confirmed in 2019 in a randomized clinical trial that compared TMR with nerve burying into a muscle. TMR is now performed at the time of amputation as a means of prophylaxis against the development of local nerve pain and phantom limb pain. The concept to “give the nerve somewhere to go and something to do” can be generalized to the treatment of any injured nerve, and therefore TMR nerve transfers have recently become a first-line surgical treatment for neuroma pain throughout the body.