Reconstructive Center for Lost Limbs

Our multidisciplinary clinic brings together a team of experts to offer the latest advancements in surgical techniques and prosthetic technology. We view amputation as a reconstructive procedure aimed at maximizing limb function and minimizing discomfort, empowering individuals to regain mobility and independence. Our commitment is not only to address the physical aspects of limb loss but also to provide compassionate care that acknowledges the emotional and psychological impact it can have.

At each monthly clinic, led by renowned orthopedic surgeons Dr. Glenn Gaston and Dr. Bryan Loeffler, you will benefit from the expertise of prosthetists/orthotists, occupational therapists, and psychologists who work collaboratively to address every aspect of your care. From amputations of the thumb to those extending up to the shoulder, our clinic offers innovative procedures tailored to your individual needs, including nerve-mediated pain management and cutting-edge techniques such as targeted muscle reinnervation and the STARFISH procedure.

Whether the result of acute trauma, chronic infection, tumors, or vascular disease, we approach each case with a focus on definitive treatment, functional restoration, and pain management. At the OrthoCarolina Reconstructive Center for Lost Limbs, we understand the sensitivity of this journey and are here to support you every step of the way.

Make an Appointment

Reach out to RCLL@orthocarolina.com with any questions or to schedule an appointment.

Recognition

Awards:

2023 AAOS Annual Meeting Honorable Mention Best Video Theater Contribution: Mastracci JC, Gaston RG, Loeffler BJ. Regenerative peripheral nerve interfaces and targeted muscle reinnervation: Surgical technique. American Academy of Orthopedic Surgery Annual Meeting. Mar 7-11 2023. Las Vegas NV.

2022 Jamie Dianne Bulken-Hoover Award for Best Hand Paper at the Society of Military Orthopedic Surgery (SOMOS). Acute versus delayed targeted muscle reinnervation for upper extremity amputees. Posey L, Loeffler B, GastonRG.

2022 First Place Video Theater Presentation American Society for Surgery of the Hand (ASSH) Annual Meeting. Regenerative peripheral nerve interfaces and targeted muscle reinnervation: Surgical technique. Mastracci J, Loeffler B, Gaston RG.

2021 ASSH Top 5 Paper. Managing Digital Nerve Neuromas. Maslow J, Gaston, RG, Loeffler B.

JE Hanger Award for Innovation, 2020

AAOS Award Winning Movie: Gaston RG, Loeffler BJ, Tait MA, Bracey JW. Targeted Muscle Reinnervation and Its Role in Acute Management of Above Elbow Amputations; AAOS Annual Meeting; 2017 Mar 14-18; San Diego, CA

NCNextFirsts Award 2016: North Carolina Department of Commerce Acknowledgement of the top innovative accomplishments in the history of the state of NC.

Publications:

Cohen-Tanugi S, Reid R, Loeffler BJ, Gaston RG. The Prevalence of Depression and PTSD in Adults With Surgically Managed Traumatic Upper-Extremity Amputations. Hand (N Y). 2024 Jan;19(1)169-174.

Chow I, Gaston RG. Transradial amputation and wrist disarticulation. Op Tech in Orthop. 2023 Sep 33(3):1-9.

Saltzman EB, Jerome JTJ, Gaston RG. Current concepts and management of upper limb amputees. J Hand Microsurg 2023 Aug 25;15(4):245-246

Maslow JI, LeMone A, Scarola GT, Loeffler BJ, Gaston RG. Digital Nerve Management and Neuroma Prevention in Hand Amputations. Hand (N Y). 2023 Jul;18(5):838-844.

Guerrero EM, Mastracci JC, Gart MS, Garcia RM, Loeffler BJ, Gaston RG. Soft tissue management of partial hand amputation. J Hand Surg Am. 2023 Jun;48(6):612-618.

Eberlin KR, Brown DA, Gaston RG, Kleiber GM, Ko JH, Kovach SJ, Loeffler BJ, MacKay BJ, Potter BK, Roubaud MS, Souza JM, Valerio IL, Dumanian GA. A consensus approach for targeted muscle reinnervation in amputees. Plast Reconstr Surg Glob Open. 2023 Apr 5;11(4):e4928.

Denduluri SK, Rees A, Nord KM, Loeffler BJ, Gaston RG. The Starfish Procedure for Independent Digital Control of a Myoelectric Prosthesis.Tech Hand Up Extrem Surg. 2023 Mar 1;27(1):61-67.

Hysong AA, Melamed E, Delarosa MR, Daley DN, Loeffler BJ, Gaston RG. Feasibility of Nerve Transfer to Palmaris Longus in Forearm-Level TMR: Anatomic Study and Clinical Series Hand (N Y). 2022 Dec 12:15589447221137615. doi: 10.1177/15589447221137615. 

Reid RT, Johnson CC, Gaston RG, Loeffler BJ. Impact of timing on targeted muscle reinnervation on pain and opiod intake following major limb amputation. Hand (N Y). 2022 Jul 13:15589447221107696. doi: 10.1177/15589447221107696.

Grier AJ, Loeffler BJ, Gaston RG. Starfish Procedure. Hand Clin. 2021 Aug;37(3):447-455. doi: 10.1016/j.hcl.2021.04.007.

Johnson CC, Loeffler BJ, Gaston RG. Targeted Muscle Reinnervation: A Paradigm Shift for Neuroma Management and Improved Prosthesis Control in Major Limb Amputees. J Am Acad Orthop Surg. 2021 Apr 1;29(7):288-296. doi: 10.5435/JAAOS-D-20-00044.

Geary M, Gaston RG, Loeffler B. Surgical and technological advances in the management of upper limb amputees. Bone Joint J. 2021 Mar;103-B(3):430-439. doi: 10.1302/0301-620X.103B3.BJJ-2020-1184.R1.

Kaluf B, Gart MS, Loeffler BJ, Gaston G. Evaluating the Ability of Congenital Upper Extremity Amputees to Control a Multi-Degree of Freedom Myoelectric Prosthesis. J Hand Surg Am. 2021 Oct 14:S0363-5023(21)00523-2. doi: 10.1016/j.jhsa.2021.08.011.

Gaston RG. “Team Approach: Modern Day Prosthetics in the Mangled Hand.” JBJS Reviews. July 16, 2019 issue

Pierrie SN, Gaston RG, Loeffler BJ Targeted Muscle Reinnervation for Prosthesis Optimization and Neuroma Management in the Setting of Transradial Amputation. J Hand Surg Am. 2019 Jun;44(6):525.e1-525.e8. doi: 10.1016/j.jhsa.2018.11.019. Epub 2019 Feb 4. Review. PMID: 30733097

Gaston RG , Bracy J, Loeffler BJ, Tait M. “A Novel Muscle Transfer for Independent Digital Control of Myoelectric Prosthesis: The Starfish Procedure.” Journal of Hand Surgery AM 2019 Feb:44(2):163

Pierrie S, Gaston RG, Loeffler BJ. Current Concepts in Upper Extremity Amputations. Journal of Hand Surgery 2018 Jun 2

Gaston RG, Loeffler BJ: “Introducing the Starfish Procedure.” AAOS Now. 2018 Mar

Tait MA, Bracey JW, Loeffler BJ, Gaston RG. (Published Abstract) “Targeted Muscle Reinnervation and its Role in Acute Management of Above-Elbow Amputations.” JAAOS 2017 Sept;25(9)