Restoration of sensorimotor function after amputation has remained challenging because of the lack of human-machine interfaces that provide reliable control, feedback, and attachment. Here, we present the clinical implementation of a transradial neuromusculoskeletal prosthesis—a bionic hand connected directly to the user’s nervous and skeletal systems. In one person with unilateral below-elbow amputation, titanium implants were placed intramedullary in the radius and ulna bones, and electromuscular constructs were created surgically by transferring the severed nerves to free muscle grafts. The native muscles, free muscle grafts, and ulnar nerve were implanted with electrodes. Percutaneous extensions from the titanium implants provided direct skeletal attachment and bidirectional communication between the implanted electrodes and a prosthetic hand. Operation of the bionic hand in daily life resulted in improved prosthetic function, reduced postamputation, and increased quality of life. Sensations elicited via direct neural stimulation were consistently perceived on the phantom hand throughout the study. To date, the patient continues using the prosthesis in daily life. The functionality of conventional artificial limbs is hindered by discomfort and limited and unreliable control. Neuromusculoskeletal interfaces can overcome these hurdles and provide the means for the everyday use of a prosthesis with reliable neural control fixated into the skeleton.

中文翻译：

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高度集成的仿生手，具有神经控制和反馈功能，适合日常生活使用

由于缺乏提供可靠控制、反馈和附着的人机界面，截肢后感觉运动功能的恢复仍然具有挑战性。在这里，我们展示了经桡神经肌肉骨骼假体的临床实施——直接连接到用户的神经和骨骼系统的仿生手。在一名单侧肘部以下截肢患者中，钛植入物被放置在桡骨和尺骨的髓内，并通过手术将切断的神经转移到游离的肌肉移植物上来创建电肌结构。原生肌肉、游离肌肉移植物和尺神经均植入电极。钛植入物的经皮延伸提供了植入电极和假手之间的直接骨骼附着和双向通信。在日常生活中使用仿生手可以改善假肢功能，减少截肢，并提高生活质量。在整个研究过程中，通过直接神经刺激引起的感觉始终在幻手上被感知。迄今为止，患者在日常生活中继续使用假肢。传统假肢的功能因不适以及有限且不可靠的控制而受到阻碍。神经肌肉骨骼接口可以克服这些障碍，并为日常使用假肢提供手段，并将可靠的神经控制固定在骨骼上。