Saphenous Neuropathy Following Medial Knee Trauma

Transtendinous course of the infrapatellar branch of saphenous nerve. A contribution to the aetiology of entrapment neuropathy and modification of the existing classification

“…The IPBSN entrapment may be caused by mechanical compression of the nerve between the prominent edge of the medial femoral condyle and the tendon of the Sartorius muscle as well as due to the compression of the nerve's course through the Sartorius [8,15,21]. This observation has led to several studies on the topographic relationship between the nerve and the Sartorius muscle [4,11,16].…”

“…However, during our routine dissections we noticed that the penetrating type of the IPBSN consists of two separate subtypes; the first one passing through the muscle belly and the other piercing the tendon. Mechanical compression of the IPBSN within the Sartorius tendon has been surgically recognised as a cause of entrapment neuropathy [16]. These observations led us to conduct a study in order to differentiate the IPBSNs penetrating Sartorius tendon from those penetrating Sartorius muscle, from both an anatomical and a clinical point of view, with the aim to modify the current classification.…”

“…Moreover, other studies focused on the anatomical variations in the relationship between the IPBSN and the Sartorius muscle [4,11], leading to lesions that might have clinical importance expressed as entrapment neuropathy [8,16]. Kalthur et al (2015) [9] studied the course of the IPBSN in relation to the Sartorius muscle in 32 male cadavers and classified the variations into three types; anterior to Sartorius (presartorial) (68.7%), penetrating the Sartorius (transsartorial) (28.1%), and posterior to Sartorius (retrosartorial) (3.1%).…”

Medical Screening and Evacuation: Cauda Equina Syndrome in a Combat Zone

“…Recent research has shown that direct access to physical therapy services does not compromise patient safety. Physical therapists have proven themselves able to identify serious pathology that mimics a musculoskeletal complaint 4,17,19,21,36,38,49,51 and possess diagnostic accuracy equivalent to orthopaedic surgeons. 36,46 P hysical therapists must continually monitor patient status and act appropriately when conditions emerge that require immediate referral.…”

Primary Care Physical Therapy Practice Models

“…12,18 Experienced physical therapists, both civilian and military, can recall instances of misdiagnosed or undiagnosed patients that have been referred to them. 8,17,26,31 A perceived strength of the Army neuromusculoskeletal program is the efficiency with which patients with nonmusculoskeletal conditions are recognized and referred to the appropriate medical specialty. 12,18,23,24 The US Army model for providing expeditious and effective evaluation and treatment of patients with neuromusculoskeletal dysfunction is based on a system of quality assurance that involves 3 components: expanded clinical privileges, the use of a physical therapist or physician supervisor, and progressive educational experiences.…”