Fig. 3A–B.

(A) This photograph depicts a shoulder disarticulation amputee undergoing TMR. The neuroma has been excised (c) from the donor radial nerve (a) and the recipient thoracodorsal nerve (b) has been cut near its entry into the latissimus muscle in preparation for coaptation. (B) The recipient thoracodorsal nerve (b) has been sutured into the center of the donor radial nerve (a) using two epineurial mattress sutures. The discrepancy in nerve caliber precludes use of conventional nerve repair techniques. However, despite the obvious size mismatch, the coaptation yielded clinically useful latissimus reinnervation without evidence of neuroma formation.