fig3

Figure 3. Intraoperative pictures showing an example of surgical connection of the tibial and peroneal nerves with a graft for the treatment of traumatic neuroma years after an above-the-knee amputation. Intraoperative pictures showing (A) the neuroma at the end of the tibial and peroneal nerve, forceps holds the tibial part; (B) after resection of the neuroma, the tibial nerve end is marked 3 cm proximally to the freshly cut end (C) after connection of the tibial nerve end to the peroneal nerve end with two 10-0 sutures on the inner curve, the tibial nerve is transected at the marked site and directly repaired with 4x 10-0 sutures, (D) the end result after two extra 10-0 sutures have been placed at the tibial-peroneal coaptation site, and both coaptation sites have been sealed with fibrin glue (Tisseel, Baxter). This technique is slightly different from the illustration in [Figure 2], but has the advantage that the graft can be more easily handled.