The Anatomical Course of the Lateral Femoral Cutaneous Nerve with Special Attention to the Anterior Approach to the Hip Joint

被引:86
|
作者
Rudin, Diana [1 ]
Manestar, Mirjana [2 ]
Ullrich, Oliver [2 ]
Erhardt, Johannes [1 ]
Grob, Karl [1 ]
机构
[1] Kantonsspital, Dept Orthopaed Surg, St Gallen, Switzerland
[2] Univ Zurich Irchel, Dept Anat, Winterthurerstr 190, CH-8057 Zurich, Switzerland
来源
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME | 2016年 / 98卷 / 07期
关键词
ILIAC BONE-GRAFT; CONGENITAL SUBLUXATION; SUBCUTANEOUS TISSUE; ARTHROPLASTY; OSTEOTOMY; INCISION; DISLOCATION;
D O I
10.2106/JBJS.15.01022
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Injury to the lateral femoral cutaneous nerve (LFCN) is a risk during the operative anterior approach to the hip joint. Although several anatomical studies have described the proximal course of the nerve in relation to the anterior superior iliac spine (ASIS) and the inguinal ligament, the distal course of the LFCN in the proximal aspect of the thigh has not been sufficiently studied. The aim of this cadaveric study was to examine the branching pattern of the nerve, with special consideration to the anterior approach to the hip joint. Methods: Twenty-eight cadaveric hemipelves from 18 donors (10 paired and 8 unpaired specimens) were dissected. The LFCN branches were localized proximal to the inguinal ligament and traced distally into the area of the proximal aspect of the thigh. Distribution patterns of the nerve with respect to its relationship to the ASIS and the internervous plane of the anterior approach to the hip joint were recorded. Results: We found 3 different branching patterns of the LFCN: sartorius-type (in 36% of the specimens), characterized by a dominant anterior nerve branch coursing along the lateral border of the sartorius muscle with no, or only a thin, posterior branch; posterior-type (in 32%), characterized by a strong posterior nerve branch; and fan-type (in 32%), characterized by multiple spreading nerve branches of equal thickness. In 50% of the specimens, the LFCN divided into >= 2 branches superior to the inguinal ligament. Sixty-two percent of the LFCN branches entered the proximal aspect of the thigh medial to the ASIS; 27%, above; and 11%, lateral to the ASIS. The LFCN consistently coursed within the deep layer of the subcutaneous fat tissue. Conclusions: Injury to branches of the LFCN cannot be avoided in approximately one-third of surgical dissections that use the anterior approach to the hip joint. To protect the anterior branch of the LFCN, the skin incision should be as lateral as possible. The posterior branch of the LFCN is most vulnerable in the proximal aspect of the anterior approach to the hip joint, where it can be expected to course within the deep layer of the subcutaneous tissue.
引用
收藏
页码:561 / 567
页数:7
相关论文
共 50 条
  • [41] The lateral femoral cutaneous nerve canal
    Hanna, Amgad
    JOURNAL OF NEUROSURGERY, 2017, 126 (03) : 972 - 978
  • [42] Lateral femoral cutaneous neuralgia:: An anatomical insight
    Dias, LC
    Valença, MM
    Guimaraes, FAV
    Medeiros, RC
    Silva, RAM
    Morais, MGV
    Valente, FP
    França, SML
    CLINICAL ANATOMY, 2003, 16 (04) : 309 - 316
  • [43] The lateral femoral cutaneous nerve block
    Cook, JL
    Cook, J
    DERMATOLOGIC SURGERY, 2000, 26 (01) : 81 - 83
  • [44] Lateral Femoral Cutaneous Nerve Angiomyoma
    Mugge, Luke
    Dang, Danielle D.
    Chandela, Sidhartha
    CUREUS JOURNAL OF MEDICAL SCIENCE, 2021, 13 (10)
  • [45] Bikini Incision Increases the Incidence of Lateral Femoral Cutaneous Nerve Injury in Direct Anterior Approach Hip Arthroplasty: A Prospective Ultrasonic, Electrophysiological, and Clinical Study
    Sang, Weilin
    Xue, Song
    Xu, Yiming
    Liu, Yu
    Zhu, Libo
    Ma, Jinzhong
    JOURNAL OF ARTHROPLASTY, 2021, 36 (10): : 3463 - 3470
  • [46] Incidence of Lateral Femoral Cutaneous Nerve Dysfunction After Total Hip Arthroplasty Through the Anterior-Based Muscle-Sparing Surgical Approach
    Gorur, Alaka
    Genualdi, Joseph
    Paskey, Taylor
    Blum, Christopher
    Neuwirth, Alexander L.
    Cooper, H. John
    Shah, Roshan P.
    Geller, Jeffrey A.
    ARTHROPLASTY TODAY, 2024, 28
  • [47] Anatomical Analysis of the Lateral Femoral Cutaneous Nerve and Its Passage beneath the Inguinal Ligament
    Mandal, Patrick
    Russe, Elisabeth
    Schwaiger, Karl
    Wechselberger, Gottfried
    Feigl, Georg
    PLASTIC AND RECONSTRUCTIVE SURGERY, 2022, 149 (05) : 1147 - 1151
  • [48] Ultrasound-Guided Diagnosis and Injection of the Lateral Femoral Cutaneous Nerve with an Anatomical Variation
    Palamar, Deniz
    Terlemez, Rana
    Akgun, Kenan
    PAIN PRACTICE, 2017, 17 (08) : 1105 - 1108
  • [49] A unique anatomical variation of the lateral femoral cutaneous nerve arising from the ilioinguinal nerve: illustrative case
    Yeole, Ujwal
    Zager, Eric L.
    Hanna, Amgad S.
    JOURNAL OF NEUROSURGERY-CASE LESSONS, 2025, 9 (10):
  • [50] The Anatomical Course of the Superior Gluteal Nerve With Regard to the Direct Anterior Approach for Primary and Revision Total Hip Arthroplasty
    Starke, Vasco
    Stofferin, Hannes
    Mannschatz, Sidney
    Hoermann, Romed
    Dammerer, Dietmar
    Thaler, Martin
    JOURNAL OF ARTHROPLASTY, 2021, 36 (03): : 1138 - 1142