Lateral Femoral Cutaneous Nerve

Grothaus, Matthew C; Holt, Marston; Mekhail, Anis O.; Ebraheim, Nabil A.; Yeasting, Richard A.

doi:10.1097/01.blo.0000164526.08610.97

Cited by 134 publications

(127 citation statements)

References 6 publications

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“…The nerve pierces the fascia lata beneath the inguinal ligament and runs laterally and distally within the subcutaneous tissue of the anterolateral region of the thigh 18,19 . The exit from the intrapelvic passage or entry into the thigh region can vary, as several anatomical studies have shown [19][20][21][22][23][24][25][26] . While most anatomical textbooks do not describe the distribution pattern of the LFCN in the proximal aspect of the anterolateral thigh region [27][28][29][30] , some authors describe a division of the LFCN into an anterior (femoral) and posterior (gluteal) branch after passing behind or through the inguinal ligament 18,23,24,31 .…”

mentioning

confidence: 99%

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

Rudin

Manestar

Ullrich

et al. 2016

The Journal of Bone and Joint Surgery

111

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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. Background: Injury to the lateral femoral cutaneous nerve (LFCN) is a risk during the operative anterior approach to the

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mentioning

confidence: 99%

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

Rudin

Manestar

Ullrich

et al. 2016

The Journal of Bone and Joint Surgery

111

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“…Spina ilyaka anteriyor superiorun yaklaşık 1 cm medyalinde inguinal ligamanın altından, üzerinden veya içerisinden geçebilir. Daha sonra uyluk anteriyor ve lateraline sensoryal dallar verir [5]. İntrapelvik düzeyde ilyakus kası anteriyorunda neredeyse horizontal seyreder.…”

Section: Lateral Femoral Kutanöz Sinir (Lfks)unclassified

Kalca Eklemi Cevresi Yumusak Dokulari

Balcı¹,

Gezer²

2017

Trd Sem

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GirişKalça çevresi yumuşak dokuları, cilt, cilt altı yağ dokusu, fasyal planlar, kas, sinir ve vaskü-ler dokuları da içeren geniş bir anatomik böl-gedir. Manyetik rezonans görüntüleme (MRG) bu bölgenin patolojilerinin değerlendirilmesin-de en yüksek kontrast çözünürlüğü ile öncelikli tercih edilen yöntemdir. Ayrıca direkt radyografi, ultrasonografi (US) ve bilgisayarlı tomografi (BT) gerektiğinde kullanılabilen diğer görüntüleme yöntemleridir. Bu başlık altında, sıklıkla görülen patolojilerin radyolojik görün-tüleme bulgularının tartışılması hedeflenmiştir. Tuzak NöropatilerTuzak nöropatiler, karmaşık klinik bulguları nedeniyle tanı koymada güçlük yaşanan patolojilerdir. Periferik sinirlerin akut veya kronik hasarına sekonder ortaya çıkan ağrı ve fonksiyonel bozukluk ile karakterizedir. MRG, tuzak nöropatilerin tanısında kullanılan non-invaziv ve kullanıcıdan bağımsız görüntüleme yönte-midir. Nöral hasarlanmanın yeri ve altta yatan nedeni hakkında bilgi verir, cerrahiden fayda görebilecek hastaları belirlemeye yardımcı olur ve selektif sinir blokajı için yol göstericidir [1].Manyetik rezonans görüntüleme ile kalça ve pelvisin tuzak nöropatilerinin görüntüleme-sinde T1 ve T2A görüntüler kullanılmaktadır. İdeal görüntüleme planı sinir trasesine göre değişir ancak sıklıkla aksiyal kesitler yararlıdır. T2A görüntüler elde edilirken eko zamanı uzun seçilir. Görüntü alanındaki vasküler yapılardan gelen sinyalleri baskılamak amacıyla RF pulsunun olduğu "satürasyon" ve yağ sinyalini baskılamak amacıyla "yağ baskılama" teknikleri kullanılır. Ayrıca yağ baskılamalı "ağır T2" görüntüler sinyal intensite değişikliklerini belirginleştirir.Periferik sinirler veya sinir demetleri, T1A serilerde kas ile izointens, T2A serilerde izo-hafif hiperintens longitudinal yapılar şek-

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“…Murata et al 14 looked at 108 LFCNs and found 41% cross the level of the inguinal ligament over, or lateral to, the anterior superior iliac spine (ASIS). The LFCN divided into its branches prior to passing the inguinal ligament in 28% of specimens in one study, 15 and four branching patterns have been identified in the proximal thigh. 16 Grothaus et al 15 have established a 'danger zone' in the anterior thigh where nerve branches are invariably found.…”

mentioning

confidence: 96%

“…The LFCN divided into its branches prior to passing the inguinal ligament in 28% of specimens in one study, 15 and four branching patterns have been identified in the proximal thigh. 16 Grothaus et al 15 have established a 'danger zone' in the anterior thigh where nerve branches are invariably found. This is a rectangular area 7 cm medially and 12 cm inferiorly from the ASIS.…”

mentioning

confidence: 96%

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Injury to the Lateral Femoral Cutaneous Nerve During Minimally Invasive Hip Surgery: A Cadaver Study

Jameson

Howcroft

McCaskie

et al. 2008

annals

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PATIENTS AND METHODS Fifteen cadaveric hip specimens were dissected to establish the course of branches of the lateral femoral cutaneous nerve. The number of branches divided by each of the three incisions was recorded. RESULTS The MIS incisions resulted in significantly less nerve division compared with the SLA. The mean difference between the SLA and the ALA was 4.4 (P < 0.0001), and between the SLA and the PA was 1.4 (P = 0.0005). The ALA divided significantly fewer nerves compared with the PA (mean difference = 3; P = 0.0001). DISCUSSION There is little evidence of the benefit of one MIS approach over another in the literature. The ALA preserved significantly more cutaneous nerves in this study. These results need corroboration with clinical outcomes to determine their significance.

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Lateral Femoral Cutaneous Nerve

Cited by 134 publications

References 6 publications

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

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

Kalca Eklemi Cevresi Yumusak Dokulari

Injury to the Lateral Femoral Cutaneous Nerve During Minimally Invasive Hip Surgery: A Cadaver Study

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