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Junius Moore of Wilmington, N.C., flexes his Luke Arm at Next Step Bionics & Prosthetics in Manchester on Monday. Thanks to specialized nerve-reassignment surgery, high-tech electronics control translate nerve impulses from Moore’s stump into movement of the arm and hand. Another specialized surgery implanted a steel rod into the bone in his arm to provide the mounting point for the arm.

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Junius Moore of Wilmington, N.C., gets fitted with a Luke arm by David Beauchemin of Next Step Bionics & Prosthetics in Manchester on Monday.

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Junius Moore of Wilmington, N.C., demonstrates his Luke Arm at Next Step Bionics & Prosthetics in Manchester on Monday.

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Matt Albuquerque, right, and David Beauchemin of Next Step Bionics & Prosthetics in Manchester make the electronic connections between Moore’s Luke Arm and the collar around his amputation stump.

MANCHESTER - Prime tourist season on the North Carolina coast meant plenty of extra hours for Junius Moore at his two restaurants. He got into his BMW one July morning in 2016, tired from all the hours, and fell asleep while driving.

Moore ran off the road going 65 mph and smashed into the back of a parked garbage truck.

He was badly injured in the crash, and doctors had to amputate his left arm above the elbow.

“I could easily have died or been fairly paralyzed,” Moore recounted. “Very thankful for what I was able to walk away with.”

Moore, 35, spent three weeks in the hospital. After that, he spent six months arguing with his insurance carrier and flew halfway around the world for a special surgery.

First in the world

This week, he arrived in the Millyard to become a first-in-the-world sensation, merging the Dean Kamen-inspired Luke prosthetic arm with the specialized surgery to give him better freedom of movement.

“It’s going to make a lot of things easier,” Moore said during a fitting for the arm at the Next Step Bionics & Prosthetics on Monday.

Moore also became the first person to get his private insurer to pay for the Luke Arm, according to Matt Albuquerque, Next Step’s president. Albuquerque has been involved with the Luke Arm project since late 2006 when it was being developed. Clinical trials began in 2009.

“This is as technological as it can get in the world right now,” Albuquerque said this week. “We connect man and machine.”

Kamen, whose inventions include the first portable insulin pump, led development of the Luke Arm from his DEKA Research & Development Corp. in the Millyard. This is the latest advancement of the arm, which was funded with $40 million in federal funds.

“When (Moore) thinks about closing his hand that’s no longer there, the hand will close, so we’re using the same signals as when he had his biological arm to drive the robotic arm,” Albuquerque said.

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Junius Moore of Wilmington, N.C., gets fitted with a Luke arm by Matt Albuquerque, right, and David Beauchemin of Next Step Bionics & Prosthetics in Manchester on Monday.

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Junius Moore of Wilmington, N.C., tests his LUKE arm with David Beauchemin of Next Step Bionics & Prosthetics in Manchester on Monday.

Surgeries and tests

Since the crash, Moore has tried several prosthetic solutions, first with a body-powered hook.

“I pretty much discarded that pretty close to immediately” because it was so uncomfortable, he said. Plus, “You can’t balance a tray on a hook,” said Moore, who owns two Smithfield’s Chicken ‘N Bar-B-Q franchise restaurants.

Moore, who will demonstrate the arm before reporters today, said he spent six months fighting his insurance company, Blue Cross and Blue Shield. The North Carolina insurance board forced the insurer to pay about $200,000 for the targeted muscle reinnervation (TMR) surgery and the Luke Arm.

“You have to be your own advocate,” Moore said.

He got the TMR surgery, which reassigns the nerves that once controlled the lower arm and hand, in Oregon in April 2017. He came to Next Step two months later to see a demonstration of the Luke Arm.

After getting insurance approval in January 2018, Moore came to Next Step in March to be fitted for his nine-pound Luke, which was connected to his stump with a socket made out of plastic and carbon.

The socket proved problematic. “It got to be June and July, and I couldn’t wear it anymore,” Moore said. “I couldn’t cool it down. That was the final straw for it.”

He flew to Australia in August to get osseointegration surgery, a $75,000 cost he paid himself.

“What they did is they surgically implant a rod into the skeletal system where part of that rod actually comes outside of the skin” at the end of Moore’s stump, Albuquerque said.

His Australian doctor, Munjed Al Muderis, fled his native Iraq as a young doctor, refusing the orders of Saddam Hussein to mutilate the ears of army deserters, according to his biography.

“To date, we have performed over 500 osseointegration procedures with a high rate of success,” wrote his surgeon, Dr. Munjed Al Muderis.

Moore had to wait three months for that surgery to heal.

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Junius Moore of Wilmington, N.C., flexes his Luke arm as Matt Albuquerque of Next Step Bionics & Prosthetics watches in Manchester on Monday.

High-tech connections

In the meantime, Next Step needed to develop a way to connect the approximately 1 inch of rod extending from Moore’s stump to his Luke Arm.

“Getting them to work together, that was really our job,” Albuquerque said.

They built a small metal “collar” that goes around the rod. The rod and collar snap into a receiver, a thin metal piece smaller than a tuna can. There is a customized adapter that connects the receiver to the socket adapter, which fits into the Luke Arm.

Moore wears a cuff containing electrodes around his stump. The cuff is connected by wires to a mini computer processor and to processors inside the Luke Arm, Albuquerque said.

During a February news conference, Next Step officials introduced clients who used Bluetooth technology to control the Luke Arm. Gilford resident Chuck Hildredth demonstrated how sensors the size of matchboxes mounted on his shoes were used to help guide the Luke Arm.

“Chuck had to move his feet to make the arm move,” Albuquerque said. “Junius, because of this cuff that’s going to be up here on his residual limb, he’s now going to use his muscles to do the same thing, which means when he thinks ‘open hand,’ the hand’s going to open.”

The osseointegration surgery, he said, will make wearing the arm cooler and give the user a better feel for what the arm is doing.

Albuquerque was a fan of the 1970s television show “The Six Million Dollar Man,” which featured a man with bionic parts that gave him super strength.

“Hopefully we can do it at a fraction of the cost,” Albuquerque said.

“With this mechanical connection with the rod, us connecting nerves, we’re getting close,” he said. “As far as the function, you can sort of see how we are starting to tap into what that whole story was all about, and that is the connection between man and machine.”

Moore’s dad, Gregory, smiled at times watching his son get fitted Monday.

“It’s good to see him happy, to see him smile,” the elder Moore said.

Moore raised both arms above his head, showing off his muscles to the Next Step staff.

“You’re always grateful for all you can get, so I’m very grateful to be here,” he said.

Still, he acknowledged its limits.

“You’re never going to replace your arm.”