Fig. 4.

Intraoperative findings at the time of revision surgery for failed transhumeral pTMR. A, Marking of the incision and Tinel’s signs for case 2 at revision targeted muscle reinnervation. Preemptive targeted muscle reinnervation had been performed at the time of the transhumeral amputation. B, Both median (red vessel loops) and ulnar (blue vessel loops) nerves terminated in neuromas despite having successfully reinnervated their target (the medial head of the triceps). Note also that the median nerve takes a sharp 90-degree turn just proximal to the site of the muscle imbrication at the preemptive targeted muscle reinnervation (distal red vessel loop).