All the three men, who received a new technique called "bionic reconstruction," suffered for many years with brachial plexus injuries and poor hand function as a result of motor vehicle and climbing accidents.
It combines selective nerve and muscle transfers, elective amputation, and replacement with an advanced robotic prosthesis, using sensors that respond to electrical impulses in the muscles.
Following comprehensive rehabilitation, the technique restored a high level of function, in all three recipients, aiding in activities of daily living.
"The scientific advance here was that we were able to create and extract new neural signals via nerve transfers amplified by muscle transplantation. These signals were then decoded and translated into solid mechatronic hand function," said Aszmann.
Before amputation, all three patients spent an average of 9 months undergoing cognitive training, firstly to activate the muscles, and then to use the electrical signals to control a virtual hand.
Three months after amputation, robotic prostheses gave all three recipients substantially better functional movement in their hands, improved quality of life, and less pain.
For the first time since their accidents all three men were able to accomplish various everyday tasks such as picking up a ball, pouring water from a jug, using a key, cutting food with a knife, or using two hands to undo buttons.
Brachial plexus injuries occur when the nerves of the brachial plexus - the network of nerves that originate in the neck region and branch off to form the nerves that control movement and sensation in the upper limbs, including the shoulder, arm, forearm, and hand - are damaged.
"So far, bionic reconstruction has only been done in our centre in Vienna. However, there are no technical or surgical limitations that would prevent this procedure from being done in centres with similar expertise and resources," said Aszmann.
The research was published in The Lancet journal.
