Targeted Muscle Reinnervation in Wartime Amputation: A Review of Pediatric Literature and Feasibility in Current Conflicts

Summary: Treatment of war-related injuries is complex. The mechanism of injury, inherent infection risk, and disrupted medical infrastructure result in worse outcomes after acute extremity amputation. There have been a large number of wartime traumatic and surgical extremity amputations across the globe, namely in connection with the active conflicts in Ukraine and Gaza. Targeted muscle reinnervation is a low-risk procedure that has been shown to be effective in treating and preventing neuroma-associated pain and phantom limb pain in extremity amputation patients. Its utility in Ukraine, Gaza, and future conflicts has not been described and is important to outline. We aimed to describe the utility of targeted muscle reinnervation in the management of traumatic amputations and the overall implications this procedure could have on the adult and pediatric patients affected by these conflicts.