For the second time in a calendar year, a patient has chosen to cut off his own hand so that he could be fitted with a bionic one. It is a testament to the progress of bionics that patients are beginning to favor the technological alternative over ineffective biological treatments.


In 2001, while on vacation in his native Serbia, the patient called “Milo” was severely injured in a motorcycle accident. He skidded into a lamppost, crushing his leg and right shoulder. His leg recovered, his shoulder did not. A network of nerve fibers in Milo’s shoulder called the brachial plexus had been damaged, leaving his right arm paralyzed. In an attempt to restore activity, surgeons transplanted nerves from Milo’s leg to his arm. The procedure restored activity to the arm but the hand remained crippled. After ten years of ineffective surgery and treatment Milo’s hand remained lame. At that point Dr. Oskar Aszmann, a surgeon at the Medical University of Vienna, proposed another solution: cut the hand off and fit the arm with a bionic hand.

The bionic hand, manufactured by the German prosthetics company Otto Bock, is equipped with six sensors that overly the skin and detect neuronal signals in the forearm. The signals passing through the forearm are sent from the brain to control movement. The prosthetic translates those signals into mechanical movements. To boost the received signal, Milo underwent a surgery in which nerves and muscle tissue were transplanted to his forearm.

Milo just woke from surgery earlier this week and hasn’t had time yet to verify the operation’s success. If it does prove successful Milo will become the world's second elective amputee to receive a bionic hand.


Last year a 24-year old Austrian man named Patrick became one of the first patients ever to undergo ‘elective amputation’ surgery. He’d lost the fingers on his left hand after being electrocuted at work and, after three years without the use of his hand, Dr. Aszmann offered his unique solution.

Now, Patrick can tie his shoes again, and he can fill a glass with water without dropping or breaking it. The bionic hand is the same one from Otto Bock that Milo was just fitted with. Watch the video below to see Patrick demonstrate the amazing functionality of his new hand.

As you can see, the Otto Bock hand is very versatile. As engineer Andrei Ninu describes, it has three degrees of freedom: wrist rotation, wrist flexion and extension, and finger movements. The fingers can form a pinch grip or a whole hand grip. It’s evident from the video that the movements aren’t entirely smooth, but that’s understandable. The translation of signals originating in the motor cortex–the part of the brain that controls movement–as they pass through the forearm into fine bionic movements is a complex, multistep process that still has much room for improvement. Nonetheless, Patrick’s amazing demonstration shows us that the field of bionic prosthetics has made incredible progress.

Prior to Patrick’s surgery, Dr. Aszmann held a symposium with senior surgeons to discuss its ‘elective amputation’ aspect. Included among the invitees was a theologian. Not everyone was keen on voluntarily cutting off parts of the human body. Many of Dr. Aszmann’s fellow surgeons were in fact against Patrick’s amputation, arguing for continued surgeries and therapy. He rejected their protests and ushered in a new era in which amputation-requiring bionics are no longer a last resort, but a viable alternative.

One of the major obstacles to creating the ideal prosthetic–one with equal or greater functionality than a real limb–is the need for a sensory feedback system. Imagine having to watch the carton of milk in your hands to make sure it doesn’t slip, or having to consciously swing your arms as you walk. Most of today’s prosthetics require constant attention by their users. Otto Bock is developing a technology to close the loop of sensory feedback. Vibrations generated by the prosthesis would signal back different realtime parameters such as grasping formation, velocity, or hand position. Rather than concentrating on the movements, the amputees would simply feel it.

As you can tell from Patrick’s demonstration, bionics technology is making great strides. These bionic hands are the first of their kind, and they add to the growing number of body parts–including knees, arms and eyes–that technology can augment or replace with increasing effectiveness. Touch Bionics also has an impressive hand on the market that can be tailored to each patient's disability.

After waking from his surgery, Milo said he felt good and that he was eager to get on with his life. The 26-year old has good reason to believe that his new bionic hand will return his ability to perform so many of the functions he used to take for granted. Hopefully we’ll soon see him tying his shoelaces again, gripping glasses of water–heck, he might even take his bike out for a spin.

[image credit: BBC]

image: Milo
video: Patrick

Peter Murray was born in Boston in 1973. He earned a PhD in neuroscience at the University of Maryland, Baltimore studying gene expression in the neocortex. Following his dissertation work he spent three years as a post-doctoral fellow at the same university studying brain mechanisms of pain and motor control. He completed a collection of short stories in 2010 and has been writing for Singularity Hub since March 2011.