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With time and practice, a patient is able to fine-tune the way the robotic arm works with his or her body.
The first memory David Scott has following his traffic accident July 31, 2017, is a paramedic leaning over trying to help release him from underneath his 18-wheeler. “I’m trying to pull my arm out and they’re telling me I can’t,” Scott said. “So I turn around and try and force it. But they stopped me.” That’s because at that moment, Scott wasn’t fully aware how badly his arm had been damaged. When he arrived at UAMS, his surgeons were not able to save it. And not just the arm, they and had to amputate up to his chest. “Typically if an extremity is reconstructable, we will reconstruct it,” said Mark Tait, M.D., an orthopedic hand and upper extremity surgeon. “In this case, his nerves, arteries and vessels were so severely damaged we had to do an amputation.” But Tait and John Bracey, M.D., another UAMS orthopedic hand and upper extremity surgeon, were thinking beyond the loss of Scott’s arm. They had plans for his future. Traditionally, Tait said, patients can receive body-powered prosthetics. But new technology allows advanced robotics to be used by amputees. Because the surgeons decided to prepare Scott to be able to use a robotic arm, the surgery took about seven hours. Tait and Bracey identified the nerves that once flowed in his hand, wrist and elbow. They then took those nerves and plugged them into other muscles in Scott’s chest. With time, the nerve would reinnervate—supply energy to—that muscle, causing it to have a new function. So now when Scott thinks, “close hand” or “bend elbow” new muscles, operated by nerves formally in his arm, respond. That response is sensed by his robotic arm, which follows the brain’s command. “David is very highly motivated,” Bracey said. “He understood the severity of his injury but was determined not to be limited by that. His motivation helps make this so successful.”
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