Enhancing Quality of Life After Partial Brachial Plexus Injury Combining Targeted Sensory Reinnervation and AI-Controlled User-Centered Prosthesis: A Case Study

Background/Objectives: Upper limb amputation presents considerable physical and psychological challenges, especially in young, active individuals. This case study outlines the rehabilitation journey of a 33-year-old patient, an Italian national Paralympic snowboard cross athlete, who underwent elective transradial amputation followed by advanced surgical and prosthetic interventions. The objective was to assess the combined impact of upper limb Targeted Sensory Reinnervation (ulTSR) and the Adam’s Hand prosthetic system on functional recovery and user satisfaction. Methods: After a partial brachial plexus injury caused complete paralysis of his right hand, the patient opted for transradial amputation. He subsequently underwent ulTSR, performed by plastic surgeon, Alexander Gardetto, MD, which involved rerouting sensory nerves to defined regions of the residual limb in order to reestablish a phantom limb map. This reinnervation was designed to facilitate improved prosthetic integration. The Adam’s Hand, a myoelectric prosthesis with AI-based pattern recognition, was selected for its compatibility with TSR and intuitive control. Outcomes were evaluated using the OPUS questionnaire, the DASH, and patient feedback. Results: ulTSR successfully restored meaningful sensory input, allowing intuitive and precise control of the prosthesis, with minimal cognitive and muscular effort. The patient regained the ability to perform numerous activities of daily living such as dressing, eating, lifting, and fine motor tasks—which had been impossible for over 15 years. OPUS results demonstrated significant improvements in both function and satisfaction. Conclusions: This case highlights the synergistic benefits of combining ulTSR with user-centered prosthetic technology. Surgical neurorehabilitation, paired with advanced prosthetic design, led to marked improvements in autonomy, performance, and quality of life in a high-performance amputee athlete.